WHO worried about 'transplant tourism'

The great majority of transplants are performed in the developed world.

By JUDY SIEGEL
organ transplant 88 (photo credit: )
organ transplant 88
(photo credit: )
The World Health Organization is concerned about growing "transplant tourism," in which people from industrialized countries travel to poor countries to obtain transplant organs. Nevertheless, the great majority of transplants are performed in the developed world, according to new statistics from the WHO. In 2005, 66,000 kidney transplants were performed around the world, and six out of 10 were in industrialized countries, the WHO said. Some 75 percent of the more than 21,000 liver transplants and 6,000 heart transplants were performed in countries with industrialized or emerging (as opposed to stagnant) economies. The WHO's Global Consultation on Transplantation in Geneva last week presented a blueprint for guiding principles on cell, tissue and organ donation and transplantation. The global shortage of human organs and tissues for transplantation; quality, safety and efficacy issues related to transplantation procedures; traceability and accountability of human materials crossing borders were all discussed. A central theme of the discussions was WHO's concern over increasing cases of commercial exploitation of human materials. "Human organs are not spare parts," said Dr. Howard Zucker, WHO assistant director-general of health technology and pharmaceuticals. "No one can put a price on an organ which is going to save someone's life." "Nonexistent or lax laws on organ donation and transplantation encourage commercialism and transplant tourism," said Dr. Luc Noel, the WHO official in charge of transplantation. "If all countries agree on a common approach and stop commercial exploitation, then access will be more equitable and we will have fewer health tragedies." The WHO insists that the organ recipient and donor must be the main concern both as patient and as human being; that commercial exploitation of organs denies equitable access and can be harmful to both donors and recipients; that organ donation from live donors poses numerous health risks that can be avoided by promoting donation from deceased donors; and that quality, safety, efficacy and transparency are essential if society is to reap the benefits transplantation can offer. "Live donations are not without risk, whether the organ is paid for or not. The donor must receive proper medical follow-up but this is often lacking when he or she is seen as a means to making a profit," said Noel. "Donations from deceased persons eliminate the problem of donor safety and can help reduce organ trafficking." Israel's Rabin Medical Center-Beilinson Campus in Petah Tikva last week performed Israel's first live donor lung lobe transplant, in which - due to the lack of cadaver lungs - the young brother and sister of a 35-year-old man with lung disease donated a lower lobe to save his life. WHO action on transplantation will be aided by a global observatory set up in Madrid under the auspices of the Spanish government. The observatory will provide an interface for health authorities and the public to access data on donation and transplantation practices, legal frameworks and obstacles to equitable access. The global forum on transplantation will be spearheaded by the WHO to assist developing countries initiating transplantation programs and work towards a unified global coding system for cells, tissues and organs. Transplantation is increasingly seen as the best solution to end-stage organ failure. End-stage kidney disease, for instance, can be cured only with a kidney transplant. Without it, the patient will die or require dialysis for years, which is an expensive procedure and often out of reach of poorer patients. Transplantation is the only option for some liver conditions, such as severe cirrhosis or liver cancer, and a number of serious heart conditions. Recent estimates communicated to WHO by 98 countries show that the most sought after organ is the kidney. The 66,000 kidneys transplanted around the world in 2005 constitute only 10% of the estimated need. "Transplant tourism" represents an estimated 10% of global procedures. The phenomenon has been increasing since the mid-1990s, coinciding with greater acceptance of the therapeutic benefits of transplantation and with progress in the efficacy of the immuno-suppressant medications used to prevent the body from rejecting the foreign organ.