Tuesday, August 4, 2009

Black market for kidneys: in the US?

The recent arrest in NJ of an alleged international kidney broker may eventually shed some light on the question of how much paid kidney donation may be going on in the U.S. itself. Here's an AP story that raises the question:

Lax hospitals may be fostering kidney-selling
"A look-the-other-way attitude at some U.S. hospitals may be fostering a black-market trade in kidneys, transplant experts say. Some hospitals do not inquire very deeply into the source of the organs they transplant because such operations can be highly lucrative, according to some insiders. A single operation can bring in tens of thousands of dollars for a hospital and its doctors."
"Mark McCarren, a New Jersey federal prosecutor involved in the case, said Rosenbaum indicated that the transplants he brokered took place at more than one U.S. hospital and that the hospitals were duped and were not in on the scheme.
According to prosecutors, Rosenbaum was shockingly familiar with the U.S. system and how to beat it. Sellers and recipients would concoct stories about being relatives or friends to fool hospitals into thinking no money was changing hands, McCarren said."

How large a kidney black market exists in the U.S. is an open question. A suggestion that it might not be very large at all was made at a recent transplant conference I attended, by the eminent transplant nephrologist Gabriel Danovitch, who showed some data suggesting that the socioeconomic status distribution of unrelated donors looked a lot like that of related donors. The idea is that, if there were a lot of under the table payments being made, you would expect unrelated donors to be poorer and less educated and perhaps more foreign than related donors...

Here's an earlier post on the subject.

And (not really related) here is an episode of the Daily Show with Jon Stewart that, around minute 7, has a skit lampooning organ sales, immediately following the opening discussion of health care reform.

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