Organ Panics

Transplant medicine is what some of its strongest proponents, transplant surgeons, call a "victim of its own success." Anyone who is mortally sick with organ failure -- whether the heart, lungs, liver, or kidneys -- will grasp at anything for a second chance at life. The promise held out to those on the official organ waiting list is the "gift" of a "fresh," healthy, undamaged organ. The problem is that as of now, 108,947 Americans are stranded on the UNOS waiting list. The odds of getting a legal, 'clean' organ are slim. In the first half of 2010 there were only 14,141 transplants provided through the gift of living related or deceased donor organs. Something is a bit batty here. The data are skewed by the US system that allows just about anyone -- even those who are so desperately ill the chance of surviving a transplant is almost nil and people over 80 years old -- to be listed on the official organ list. Unlike Central Europe where 'presumed consent' operates ( that is, you are donor unless you say that you are not a donor at brain death) or in the UK where both organs and waiting lists are carefully rationed and rationalized by the National Health Service or in Norway where giving a kidney or one lung or half a liver is considered not too much to ask a loved one to provide, we in the United States have allowed our official waiting list to run riot. The result is that some sick grandparents are now being coaxed to ask their 18 year old grandchildren to fork up a spare kidney so that the Grandma can live to see her great-grandchildren, presumably.

Organ scarcities, real or exaggerated, produce real organ panics, as those who are low-listed for an official UNOS organ try to solve their problem by illegal and sometimes criminal means, including traveling to a country in the third world to buy an organ through transplant brokers, some of whom, in real life, are surgeons. In a few weeks the CEO of South Africa's leading private hospital corporation, Netcare, and five highly skilled university-affiliated Durban transplant surgeons , nephrologists, and transplant coordinators will appear in court facing criminal charges of over 100 counts of fraud, forgery, physical assault with a deadly weapon (the scalpel) and organized crime. The Netcare team fell like a ripe piece of fruit into the hands of international organs brokers who enlisted them in a big money-making scheme that trafficked poor people from rural Romania and Moldova, and slum dwellers from Northeast Brazil to Durban and Johannesburg to provide one of their 'spare' kidneys -- fresh kidneys -- to more than one hundred transplant tourists, most of them from Israel, a few from Europe and one lonely American who signed up to pay between $150,000 and $180,000 for their South African transplant safaris. The surgeons and Net care administrators thought that the 'brokers' and 'intermediaries' would be charged, not themselves. They told South African police investigators that they were duped by international criminals. But Captain Louis Holmberg, head of the Durban criminal crime branch of the South African police force, listened and nodded his head sagely while taking notes, interviewing the brokers, buyers, sellers and other intermediaries in the scheme and confiscating the hospital files from the Net care Transplant clinic in St. Augustine's hospital in Durban. In the end the government charged the doctors and hospital CEOs. Who's the felon? Captain Helberg asked rhetorically at a Berkeley Conference in May organized by Organs Watch. "Who's got the knife?" Both South Africa's Human Tissues Act and the Prevention of Organized Crime Act are involved in the trials scheduled for the beginning of 2011.

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