Consider selling organs unethical

30,000 euros for a kidney

NEW ISENBURG. One day his patience ran out. Things had been going downhill for months. He had to undergo dialysis three times a week after his kidneys had "finally quit" due to a genetic defect.

Then Willi Germund made a decision: he no longer wanted to wait "patiently in the Eurotransplant waiting list lottery", he wanted to act. And that's why he looked for a donor organ on the international black market.

"People who are threatened with death, it is said, do almost anything to avoid it," the journalist and long-time Southeast Asia correspondent now writes in his book "Kidney Against Money".

"I am the walking incarnation of a patient who has bought a future on the flourishing, but globally outlawed, legally regulated organ market that many consider reprehensible."

The blurb promises a "highly exciting insight into the medical tourism and organ trade business". In order to market this publicly, Germund appeared on Markus Lanz's talk show to present his work.

"Unvarnished representation"

Organ trafficking

The UN estimates that at least 10,000 kidneys are illegally transplanted every year.

Experts | the documentation "Black Market Organ Trade" (2013) assume that more than 500 million dollars are turned over annually.

Willi Germund describes his experiences in "Kidney Against Money" (Rowohlt, 9.99 euros, ISBN 978-3-499-61745-4).

"This book is not intended to be a provocation," the author makes clear in the preface - this is not only accused by the first reader comments on the Internet. "It certainly doesn't justify my decision to buy a new kidney.

But it is also not a guide on how to get a kidney, a heart or even a lung on the international organ market. "But what is it then?

"With this book I am primarily trying to present the subjective point of view of a person affected without make-up," the author explains his intention.

According to his statement, more than 75,000 people look for a new kidney on the international black market year after year. Those who can pay between 30,000 and 150,000 euros here.

The German Society for Nephrology (DGfN), the Federal Association of Kidneys and the Association of German Kidney Centers (DN) take a clear position on this.

"Organ trafficking is not only ethically questionable, but also rightly a criminal and punishable act in Germany and in almost all other countries in the world," the associations announced in a joint statement immediately after the book was published.

"The often young donors from third world or emerging countries who sell a kidney for a relatively small amount are left in the dark about possible health risks. As a rule, they are not given any follow-up care."

Health Risks for Donors

"This book is not intended to be a provocation," the author makes clear in the preface - this is not only accused by the first reader comments on the Internet.

"It certainly does not justify my decision to buy a new kidney. But it is also not a guide on how to get a kidney, a heart or even a lung on the international organ market."

But what is it then? In fact, in the Germunds case, it was a young African who saved him: The 28-year-old Raymond wanted to use the money to build his own business.

Germund only vaguely touches on the health risks that arise for his lifesaver.

But these are by no means small, as a look at the only country in the world where the commercial live organ trade has been allowed since 1988: Iran.

The 2001 study "Quality of life in Iranian kidney donors" by Kermanshah University showed that 58 percent of the 300 organ sellers surveyed said their general health was "very negative" six to 132 months after kidney removal.

85 percent of the sellers would definitely not sell their kidney any more, 76 percent would strongly advise potential kidney sellers against "repeating their mistake".

In this country, the procedure for living kidney donation has been regulated in the Transplantation Act since 1998 and in its amendment since 2012.

One of the most important prerequisites is - besides the health conditions - the personal relationship between donor and recipient.

"The high demands placed on the personal connection between donors and recipients are specifically designed to protect donors," emphasizes Ralf Zietz, Chairman of the Living Kidney Donation Interest Group.

"An organ donation may only be made of one's own free will and without commercial pressure," explains the German Organ Transplantation Foundation (DSO).

The challenge of living donation is more topical than ever: In the last ten years, living kidney donation has increased in importance due to the lack of organs and the resulting waiting times of up to seven years for a transplant.

According to the University of Munich Clinic, the share of living donations in the total number of kidney transplants in Germany is currently around 25 percent.

According to the DSO, serious complications only occur in around one percent of cases in this country - in contrast to the international black market.

Because it looks different here: Not only do the donors bear high health risks due to a lack of follow-up care, complications can also arise for customers who are willing to pay, emphasizes Dr. Michael Daschner from DN.

"We, as kidneys, do experience that patients come back from a stay abroad with a new kidney, but are infected with hepatitis C or HIV during the transplant."

Instead of calling for the legalization of organ trafficking, the nationwide kidney associations agree that "it should be considered how the blatant shortage of donor organs can be remedied in the long term and thus ultimately also the illegal organ trafficking can be destroyed".

More donor organs needed

"It certainly does not justify my decision to buy a new kidney. But it is also not a guide on how to get a kidney, a heart or even a lung on the international organ market." But what is it then?

"Of course, the top priority must be to restore the population's trust in organ donation," explains Professor J├╝rgen Floege, President of the DGfN.

"Above all, it must be made known that the control instruments have been strengthened and gaps in the system have been closed."

Experts fear that publications such as those by Willi Germund are counterproductive in order to rebuild the trust that has undoubtedly been lost in organ donation in Europe.

According to Eurotransplant, the number one challenge that organ donation is confronted with is already planning "low resources due to a lack of donor organs".

If enough donor organs were available, Floege points out, the illegal trade would be broken up. Germund would not have had to buy a kidney from a 28-year-old African.