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Did He Really Sell a Kidney for an iPad?

This is the first installment in a three-part series by Michele Goodwin on organ transplantation.

Chinese media report that a 17-year-old boy, identified only as Little Zheng, has sold one of his kidneys on the black market in China, purchasing an iPad with the proceeds.  This sensational story may or may not be true.  The BBC picked up the report over the weekend, lending to its credibility.  Even if found to be a hoax, the story is a potent, horrific reminder of a very real international problem: black markets in organs have proliferated around the globe.

In the past five years, underground black-market networks have been tracked and thoroughly documented in Pakistan, India, Brazil, South Africa, and even in the United States.  Last year, a New York Rabbi, Levi Izhak Rosenbaum, was arrested for operating a multinational organ-selling business, which involved bringing Israelis into the United States and selling their organs for as much as $160,000.  According to the indictment, Rosenbaum pocketed most of the money, giving only a few thousand dollars to the organ sellers. An FBI wire caught Rosenbaum describing his trade as “matchmaking.”

In Little Zheng’s case, he did not receive anywhere near $160,000 for his kidney, which fits with most black-market organ selling.  On the black market everyone gets ahead—except the supplier.  The patient, doctors, and brokers all receive a tangible benefit.  According to the BBC, Little Zheng received under $3,500 for the kidney—just enough for his iPad and some electronics.  Who knows how much the broker received—probably a lot more than the value of a glitzy Mac computer. Little Zheng’s story and those like it are not a testament to the power of a Mac.  No, the real tragedy is that men, women, and children from around the globe have been exploited for their organs in shady transactions that expose entrenched poverty and the continued vulnerability of the politically disenfranchised citizens in developing countries.

In recent years, China has cracked down on black markets and made commitments to move away from the more nefarious reputation it gained from executing Chinese prisoners and selling their organs to desperate Americans and Europeans.

Some might read the take away from Little Zheng’s story as a warning against incentives for organs, but that would be short-sided and incomplete.  Don’t get me wrong, black markets in organs are illegal and brokers should be prosecuted to the fullest extent of the law for coercing, exploiting, and otherwise harming organ suppliers.  But, keep in mind, organ demand outpaces supply  and the will to live is strong—Darwinian you might say.

Organ supply is a problem in China and the United States.  In the United States, there are 111,519 patients waiting for organs.  About 7,000 people who could benefit from an organ transplant will die in 2011.  Most of those who will die are patients on the transplant wait list.  The  patients who will hang on this year might wait six or seven years before a suitable organ becomes available.  For an increasing number of patients that length of wait-time is a death sentence. For those patients, the black market is a logical solution.

Sadly, so long as organ demand outstrips supply, we can expect to learn about many more cases like Litte Zheng’s.

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