Organ trade (also known as the blood market or the red market) is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available. Commercial trade in human organs is currently illegal in all countries except Iran. Recent bans on the commercial organ trade (e.g. India in 1994 and the Philippines in 2008) have increased the availability of transplants and the safety of the procedures. Despite these prohibitions, organ trafficking and transplant tourism remain widespread (however, the data on the extent of the black market trade in organs is difficult to obtain). The question of whether to legalize and regulate the organ trade to combat illegal trafficking and the significant global organ shortage is greatly debated. This discussion typically centers on the sale of kidneys by living donors, since human beings are born with two kidneys but need only one to survive.
History The first scientific report of the phenomenon dates back to a publication in The Lancet in 1990. The study tracked 131 patients from the United Arab Emirates and Oman who underwent kidney transplants in Bombay and who reportedly experienced numerous post-operative problems. In its report on organ trafficking in Europe, the Social, Health and Family Affairs Committee of the Council of Europe wrote: "On a global scale, organ trafficking is not a new problem. In the 1980s, experts began to notice a practice that was later dubbed 'transplant tourism': wealthy Asians traveled to India and other parts of Southeast Asia to obtain organs from poor donors. Since then, other destinations have emerged, such as Brazil and the Philippines. According to some allegations, China is involved in the trade of organs taken from executed prisoners. Organ sales continue in India despite new laws in the country that make this practice illegal in most regions. While current estimates suggest that the illicit organ trade remains relatively modest in Europe, this problem does not lose any of its seriousness, as it is very likely that with new medical advances, the gap between supply and demand for organs will continue to widen."
Legal organ trade
In Iran
Iran is the only nation that allows organs to be bought and sold. Due to lack of infrastructure to maintain an efficient organ transplant system in the early 1980s, Iran legalized living non-related donation (LNRD) of kidneys in 1988. The Charity Association for the Support of Kidney Patients (CASKP) and the Charity Foundation for Special Diseases (CFSD) control the trade of organs, with the support of the government. These nonprofit organizations match donors to recipients, setting up tests to ensure compatibility. Donors receive tax credit compensation from the government, free health care insurance, and often direct payment from the recipient with the average donor being paid $1,200. Some donors are also offered employment opportunities. Charity organizations support recipients that cannot afford the cost of the organ. Iran does place restrictions on the commercial organ trade in an attempt to limit transplant tourism. The market is contained within the country; that is, foreigners are not allowed to buy the organs of Iranian citizens. Additionally, organs can only be transplanted between people of the same nationality. Proponents of legalized organ trade have hailed the Iranian system as an example of an effective and safe organ trading model. In addition, the LNRD model is compatible with the social climate in the country. Religious practices in Iran stymies donation culture in the country as organ donations is often viewed as taboo. In 2017, from a possible 8,000 cases of brain death, 4,000 organs were viable, but only 808 were transplanted due to lack of consent. The Iranian system has been criticized as coercive, as over 70% of donors are poor. There is no short-term or long-term follow-up on the health of organ donors. There is evidence that Iranian donors experience highly negative outcomes, both in terms of health and emotional well-being. In 2023, reports from regional sources have shared details on how Iran began accepting bartered payments for organs in poor rural areas in lieu of traditional payments, in some cases even accepting goats as payment. In Iran's legal markets, the typical price paid to donors on the black market is about US$5,000, but some donors receive as little as US$1,000. In addition, black market transplants are often dangerous to both the donor and recipient, with some contracting hepatitis or HIV.
Government compensation for donors Australia and Singapore have legal monetary compensation for living organ donors. Proponents of such initiatives say that these measures do not pay people for their organs; rather, these measures merely compensate donors for the costs associated with donating an organ. For example, Australian donors receive nine weeks' paid leave at a rate corresponding to the national minimum wage. Kidney disease advocacy organizations in both countries have expressed their support for this new initiative. Although United States federal law prohibits the sale of organs, it does permit state governments to compensate donors for travel, medical, and other incidental expenses associated with their donation. In 2004, the state of Wisconsin took advantage of this law to provide tax deductions to living donors to defray the costs of donation.
Kidney paired donations
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