Organ transplantation is a common theme in science fiction and horror fiction, appearing as early as 1925, in Russian short story Professor Dowell's Head. It may be used as a device to examine identity, power and loss of power, current medical systems; explore themes of bodily autonomy; or simply as a vehicle for body horror or other fantastical plots. Organ transplantation in fiction is often used as horror and something that harms the people involved, in contrast to how organ donation is presented in real life, as something hopefully good for those involved. The circumstances of organ transplantation in fiction can vary widely. Numerous horror movies feature the theme of transplanted body parts that are evil or give supernatural powers, such as in the films Body Parts, Hands of a Stranger, and The Eye. Organ transplants from donors who are unwilling, or incapable of objecting, to having their organs removed are a recurring theme in dystopian fiction. In contrast to unwilling organ donors, there is the theme of individuals who want to donate their own life-critical organs, such as a brain or heart, at the cost of their own life. As is common in science fiction, writing about organ donation can be a way to speculate on the future of science, medicine, and autonomy, based on what occurs in the present. Narratives about organ transplants in science fiction are so widely known in public consciousness that they are occasionally referenced alongside actual medical technology developments. Explaining the advancements of his company, Revivicor, into xenotransplantation technology, David Ayares told NPR that, "[I]t's no longer a science fiction experiment. [...] It's actually a reality." Examples of casually referring to science fiction while talking about actual transplant technology can also be seen in articles such as "Beyond Science Fiction: Xenotransplantation Becoming Clinical Reality"; "Kidney xenotransplantation: Future clinical reality or science fiction?"; and "Science Fiction Comes Alive as Researchers Grow Organs in Lab".
Organ theft
The term "organlegging" was coined by Larry Niven in a series of short stories set in his Known Space future universe originally published in a 1976 collection called The Long ARM of Gil Hamilton, later expanded and re-released as Flatlander. The story The Patchwork Girl was also published alone as a novel in 1986. In Robin Cook's 1978 novel Coma, set in the present day, the organ thieves operate in a hospital, removing the organs from patients in a facility for the long-term care of patients in a vegetative state. The story was also made into a film, Coma in 1978, and later into a two-part television miniseries aired in 2012 on the A&E television network. Organ theft is a theme in a number of horror movies, including Turistas, and also (in a less overtly horrific manner) as a theme in realistic dramas such as Dirty Pretty Things and Inhale. In the TV series Trigun, the protagonist's severed left arm had been transplanted without his knowledge onto an antagonist's left shoulder. Theft of organs, with different variations, appears in urban legends around the world. One such story, about sacaojos, or eye thieves, was popular in Latin America in the 1990s. In this story, children are kidnapped by foreigners and their eyes are removed, then the children are returned. This led to several instances in real life of foreigners being distrusted on suspicion of being kidnappers. Another common urban legend about organ theft is that of the stolen kidney. This story began in Europe in the 1990s. The basic structure, whether reported orally or by media, is that a businessperson is traveling abroad, and is then abducted or seduced, and wakes up later with their kidneys having been removed, maybe noticing a dramatic scar on their lower back. This attracted real-world action, with some countries such as Germany warning their citizens to be cautious abroad. No real evidence was found for the stories that initially powered this legend. This story works as a cautionary tale to be aware of strangers, or as a tragedy of exploitation if the victims were children or had minimal agency, and fueled xenophobia.
State-sanctioned organ transplants from criminals As organ transplants became more feasible in real life, the issue of not having enough donor organs for all those who needed them became apparent. Some themes across organ transplant fiction involve various ways that the organ supply can be boosted and this problem can be solved, such as through state-organized systems that make more organs available. The same series of Larry Niven stories also contains the theme of organ donation from criminals becoming institutionalized within society to the point where even minor crimes are punished by death, in order to ensure the supply of new organs to an aging population. Niven originally developed this theme in his novel A Gift From Earth, first published in 1968 and also set in his Known Space universe. In A Gift From Earth, the descendants of colonists from an interstellar colonization mission are preyed upon by the descendants of the crew, who enact laws that make even the most minor offences carry the death penalty to allow their organs to be "harvested" and stored in "organ banks" for later use. The theme had previously been explored by Frederik Pohl and Jack Williamson in their 1964 novel The Reefs of Space, the first novel of their Starchild Trilogy, in which mankind labours under the "Plan of Man", enforced by computers within a surveillance state. Unlike in Niven's novels, donors are kept alive for as long as possible to enable more organs to be removed for transplant until they eventually succumb from their injuries. The novel also features a Frankenstein-like theme of a man assembled entirely from the body parts of others. In Sui Ishida's 2014 dark fantasy manga series, Tokyo Ghoul, a state sanctioned organ transplant is performed between an unwilling donor and the main character of the series. It was the subject of much controversy in the series itself. Unbeknown to the surgeons however, the unwilling donor was a ghoul, a monster who eats human flesh, causing the main character to have ghoul-like characteristics.
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