Putting a stop to organ trafficking and tourism
I f you required an organ transplant
and a donor was not currently available,
Asia, as well as some from Europe and
North America (2).
ceutical companies, and funding bodies.
Sayegh stressed that much of the work
would you be willing to buy the organ Organ vendors mainly come from vul- that has been going on in the months
you needed? That was the question that nerable populations, and particularly from since the Declaration was finalized has
Mohamed Sayegh (Figure 1), director impoverished populations in developing been to ensure that there is a defined
of the Transplantation Research Center countries such as Pakistan, the Philippines, strategy to implement it.
at Harvard Medical School, posed in a and Colombia. Sayegh said that in draft- As part of the way forward, Sayegh
session entitled “No to organ traffick- ing the Declaration of Istanbul, members said that the steering committee is in the
ing and tourism: an in-depth discussion of the steering committee had paid utmost process of forming a Custodian Group
regarding the Declaration of Istanbul” at attention to the concerns and issues raised that will oversee the implementation of
Renal Week 2008, the American Society of by representatives from the countries most the Declaration. There are also a num-
Nephrology Annual Meeting. affected by the problem. Ultimately, the ber of task forces being convened, which
Although no one in the room answered Declaration was agreed upon by consensus will communicate with medical societies,
in the affirmative, all four members of among the 150 participants in the summit pharmaceutical companies, and fund-
the discussion panel — physician-scien- ing bodies to develop rules by which each
tists based in the United States and Can- entity should abide and to determine the
ada — said that they see patients who have consequences of not adhering to the rules.
traveled abroad to be transplanted with The goal is to ensure that those involved
kidneys that they have purchased. All the in organ trafficking are no longer accepted
panel members agreed that they would by their respective communities and will
now be very vocal in telling patients that therefore find it much harder to continue
this is not something they should consid- the practice. Sayegh also noted that the
er. However, they all admitted that before Custodian Group is hoping to connect
they got involved with the Declaration of with journals to further develop ethical
Istanbul, this might not have been the case. policies that have the same effect.
As Sayegh put it, before he learned more Other task forces have already been
about the subject and became a member deployed to talk to government agen-
of the Steering Committee of the Istanbul cies in areas that are known hotspots for
Summit, he had always thought, so what? organ trafficking and transplant tour-
The recipient gets a kidney and the donor ism. Sayegh said that through the strong
gets much-needed money. local networks that are being built, they
The Declaration of Istanbul on Organ have received feedback about the activities
Trafficking and Transplant Tourism (1) going on in these regions, and that in some
Mohamed Sayegh is a member of the steer-
is the result of a summit in Istanbul con- ing committee that drafted the Declaration instances the individuals involved have
vened by The Transplantation Society and of Istanbul on Organ Trafficking and Trans- been sanctioned by the medical societies
the International Society of Nephrology plant Tourism. to which they belong.
to discuss organ trafficking, transplant Despite the achievements so far, Sayegh
tourism, and transplant commercialism. was keen to point out to the JCI that the
Although organ transplantation has pro- — individuals (physicians and scientists, Declaration of Istanbul is not going to
longed and improved the lives of many representatives of governmental and social make organ trafficking disappear. He lik-
people throughout the world, there is a agencies, social scientists, legal scholars, ened it to drug trafficking, saying that
widespread shortage of donors, which is and ethicists) from all but one of the 79 because money is involved it is impossible
one of the main factors that has led to the countries that perform kidney transplants. to eradicate. However, he promised that the
global problems of organ trafficking and Key to the Declaration are its defini- Custodian Group will do everything it pos-
transplant tourism. The WHO has esti- tions of the activities it seeks to combat: sibly can to curb the practice and make life
mated that approximately 10% of organ organ trafficking, transplant commercial- hard for those involved.
transplants performed throughout the ism, and transplant tourism (1). However,
world involve these practices. However, Sayegh told the JCI that the most impor- Karen Honey
this percentage is much higher in many tant issues raised in the Declaration are 1. Steering Committee of the Istanbul Summit. 2008.
developing countries: one study indicates those that address how to implement it, Organ trafficking and transplant tourism and
that by 2006, two-thirds of the 2,000 kid- and that central to implementation is commercialism: the Declaration of Istanbul. Lancet.
ney transplants performed in Pakistan communication with the many groups 372:5–6.
2. Naqvi, S.A., Ali, B., Mazhar, F., Zafar, M.N., and
were for foreign recipients, most of whom involved, including physicians, medical Rizvi, S.A. 2007. A socioeconomic survey of kidney
came from the Middle East and South societies, government agencies, pharma- vendors in Pakistan. Transpl. Int. 20:934–939.
The Journal of Clinical Investigation http://www.jci.org Volume 119 Number 3 March 2009 425