Yuan a Kidney?

by Sally Satel

Slate
June 13, 2011

China's record on organ trafficking is by now a well-known international horror story. The vast majority of organs transplanted each year in Chinese hospitals are taken from executed criminals—and allegedly from political detainees, such as members of the the Falun Gong; charges that are currently under investigation by the U.N. Human Rights Council and Amnesty International. Now, paradoxically, China is proposing forward-thinking transplant policies; commendable laws that, if properly carried out, challenge the status quo and major international health organizations.

China's black market is why paying patients—citizens as well as foreigners—can get a new kidney or liver in a matter of days or weeks. Such lightning speed is unheard of in countries without black markets in organs; in countries that rely solely on altruistic giving, the wait for a deceased-donor organ is years long. In major cities in the United States, for example, it is not unusual for patients on dialysis to wait eight or 10 years before a kidney becomes available—a wait that only about half can survive.

Last winter, a 26-year-old migrant worker from Hunan made headlines in the Chinese press because he wanted to sell a kidney to pay off gambling debts. A black-market broker promised him 40,000 yuan (about $6,000), but at the last minute the migrant worker got cold feet. According to the man's story, the broker then took him to a small hospital and bound him to an operating table, where a nurse sedated him and surgeons removed his left kidney. Authorities are now investigating, but China's thriving kidney trade makes accounts like these sound quite plausible.

In 2007, China began licensing transplant centers in an effort to raise standards of practice and regulate performance. Only 163 of the more than 600 centers qualified and are now authorized to perform transplants, the vice minister of health Huang Jiefu, told the Lancet in an article published earlier this month. Huang, who is regarded as uncommonly open about his aversion to using prisoners as the major source of transplantable organs, still acknowledges that the market is far from moribund. Indeed, the same Lancet article notes that transplant specialists in the United States and Europe say they still occasionally see patients who report having purchased their transplants in China.

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