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Organ trafficking

BMJ 2008; 337 doi: (Published 01 September 2008) Cite this as: BMJ 2008;337:0809296
  1. Ruth De Las Casas, medical student1
  1. 1St George's Hospital Medical School, London

Ethical questions increasingly overshadow the science of organ transplantation, writes Ruth De Las Casas

In May 2008 in response to the global problem of organ trafficking, the Declaration of Istanbul was signed at an international summit of nearly 80 countries. It demanded an international ban on organ trafficking and what is termed “transplant tourism.” Meanwhile individual countries struggle to cope with their own organ shortage.

Around the world, demand for organs continues to outstrip supply: in the United Kingdom alone about 400 people die every year while waiting for a transplant. There is an international struggle to increase the availability of donor organs, and it is illegal to pay for human tissue in most countries. Consequently, underground markets in organ trafficking thrive around the world.

The commercialisation of organ donation has been condemned as an unethical and exploitative practice that targets vulnerable people in poor countries. As well as the moral considerations there are physical implications. In countries where the practice is common the medical standards are often poor, putting the recipient and the donor at risk.

Transplant tourism

Stories of wealthy recipients travelling abroad to purchase kidneys from debt ridden living donors frequent the press. In recent years Pakistan has been described as the leading destination for transplant tourism—“the country to fly to and buy kidneys” (, because Pakistani laws do not deter transplant tourism. Figures collected in 2006 from different hospitals in Pakistan show that on average 30 people sold their …

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