Health officials fearful of organ black market

By Christopher Heredia, San Francisco Chronicle For Scripps Howard News Service August 14, 2002

Facing at least a five-year wait on the national kidney transplant list, Leonard Becker finally found what he needed - on the Internet.

The 65-year-old business owner in Oakland, Calif., had tried all the traditional avenues to find relief from a life of dialysis treatments. But appeals to friends, family, local churches, even his college alumni association, all came up empty.

As a last-ditch effort, he followed a friend's recommendation and posted a "desperate appeal" for a kidney on craigslist.com last summer. Within weeks, he had found a Good Samaritan willing to help him, and Becker wandered into the complex world of organ trading.

Health officials say there is no way to track how many people in need of a transplant are finding donors online, but they say the trend is definitely on the rise.

"We're seeing it more and more frequently on Web sites," said Deborah Surlas, head of the patient-affairs committee for the United Network for Organ Sharing, a nonprofit organization under contract with the federal government to monitor the national organ-transplant waiting list.

Against a backdrop of desperate people and the reach of Internet marketing, officials worry all the elements are in place for the development of an electronic black market in body parts.

They fear it could wind up reducing the number of organs available for donation through the regular system, causing even longer delays for those who have been waiting for a donor on the national list.

"It could open a Pandora's box," said Surlas. "We're concerned about money changing hands. Then, (only) the wealthy get the organs."

Surlas, who monitors several Web sites geared to people seeking transplants, said most online offers of body parts appear to be from people with altruistic reasons. But the lack of regulations, and the difficulty of systematically monitoring the Internet, means no one knows whether illegal transactions might be taking place.

The 1984 National Organ Transplantation Act made it a federal crime, punishable by imprisonment and fines of up to $50,000, for anyone convicted of buying or selling organs. But authorities said no one has ever been convicted under the law.

Transplantation through the preferred channels typically involves a donation from a relative, co-worker or friend, or an anonymous donation received at one of the many transplant centers across the country.

Altruism was all Autumn Kruse had in mind when she responded to Becker's Craigslist posting one afternoon last summer.

"I had a gift to give," said Kruse, a 30-year-old secretary and regular blood donor. "I don't have money, and I'm very busy. It was a minimum investment."

After talking on the phone with Becker and his wife, Nancy, Kruse researched the health risks for living donors. After determining the risk of complications was low, she agreed to go through with the procedure.

The Beckers flew Kruse and her mother to the Mayo Clinic in Rochester, Minn., where Becker and Kruse were put through a battery of psychological and physical evaluations before surgery.

Dr. Mark Stegall, chairman of the division of transplantation surgery at the Mayo Clinic, said the transplantation was medically sound and that both donor and recipient have good prognoses.

"We were appropriately concerned," Stegall said. "After our questioning of the donor, our group felt this was truly an altruistic act, and it was appropriate to go through with the transplant. It's an unusual situation. There aren't that many altruistic people. They do exist, and it's great they do."

But not all online connections work out that well.

In September 1999, the Internet auction site eBay blocked the sale of a human kidney after a would-be seller posted an asking price of $25,000 and bidding went as high as $5.7 million.

Craigslist's president, Jim Buckmaster, said, "We get so many postings. Less than 1 percent are brought to our attention for scrutiny. I can see both sides of the coin. If you permit the sale of organs, I can see it leading to shady behavior. Yet I would be loath to criticize someone using the Internet to find an organ to live."

The numbers are not encouraging. Every day, 16 people die in the United States awaiting a transplant. The most-needed organs are kidneys, although people can also donate a lobe of a lung, a portion of an intestine, a segment of the liver or a part of the pancreas for transplantation.

In 2001 there were 6,081 cadaver organ donors and 6,499 living donors. During the same year, 24,076 organ transplants were completed, with 80,348 people on the waiting list at year's end and 6,124 people who died while waiting.

-- Anonymous, August 14, 2002

Answers

I wonder if I can get a new brain. . .

-- Anonymous, August 14, 2002

i'd settle for a piano, even though I can't play it.

-- Anonymous, August 14, 2002

Don't anybody go there.

-- Anonymous, August 14, 2002