Surgeons reveal 29 NHS patients bought kidneys abroad

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A senior transplant surgeon has called for a debate on paying people to donate organs after a survey showed at least 29 health service patients awaiting transplants travelled abroad to buy kidneys illegally – most with disastrous results.

A senior transplant surgeon has called for a debate on paying people to donate organs after a survey showed at least 29 health service patients awaiting transplants travelled abroad to buy kidneys illegally – most with disastrous results.

The first study of "transplant tourism" from Britain has revealed the high risks of the strategy, which involves deceit and is driven by ability to pay, not clinical need.

In more than half of the 29 cases, the transplanted kidney failed and more than one third of the patients died. The findings, published as a letter in the British Medical Journal, highlight the growing global trade in organs, fuelled by a shortage of donors, and the desperation of patients who cannot obtain transplants by legitimate means. Seven thousand people are awaiting kidney transplants in the UK but there were only 3,000 operations were last year.

Bhagat Singh Makkar, a London GP, was struck off the medical register last month for offering to procure a kidney for a patient, and a second GP, Jarnail Singh from Coventry, is to appear before the disciplinary committee of the General Medical Council on a similar charge later this year.

A small but growing number of transplant surgeons around the world say the sale of organs should be made legal to improve the supply and to safeguard those involved, given the desperation of patients and the readiness of donors to sell their body parts on the black market.

Kidney specialists at the Queen Elizabeth Hospital, Birmingham, say in the Journal that six patients from their unit have travelled to India for transplants against medical advice. Four of them died.

The specialists circulated a questionnaire to the other 32 renal units in the UK, of which 17 replied. Twelve units reported a total of 23 patients who had travelled overseas for transplants, all of them against medical advice.

Eight of the 23 patients died because of the transplant and a further five lost the transplanted kidney.

Andrew Ready, clinical director of the renal transplant unit at Queen Elizabeth Hospital, writing in the Journal with Nicholas Inston, says: "Even the most desperate dialysis patient would probably not knowingly undergo a transplant associated with a one in three chance of dying and 50 per cent chance of graft loss."

Although they condemn transplant tourism and note the worrying lack of information over what happened to the donors, they say that paid donation should be discussed. "We would prefer discussions to focus on compensated donation, limited to donors within the UK, where regulation and accepted clinical guidelines would prevent exploitation and maintain standards for donors and recipients,'' they write.

Mr Ready said yesterday that he had yet to make up his own mind on paying donors but that the debate could no longer be avoided. "It is the plight of these individuals, the desperation they are pushed into, that should highlight the need for improved donation. Increasingly we have to look at newer concepts and some may argue that there may be a role here for financial incentives."

He added: "There was a point where this could not be discussed. Surgeons said any consideration of money was completely wrong. But because of this trade in organs the debate is opening up.

"It is something that will go on and policing it is probably not possible. You can see society's view [of paid donation] may change and evolve – but whether it does so and how quickly I don't know."

The sale of organs was banned in Britain in 1989 after three doctors who offered kidney transplants using paid Turkish donors were found guilty of serious professional misconduct by the General Medical Council.

Some countries turn a blind eye to the trade. In Israel, increasing numbers of patients are travelling abroad to buy kidneys. Health insurance companies now refund the costs.

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