What is Organ Trafficking?

Organ trafficking is a form of trafficking in which individuals are exploited for their organs. The victims of organ trafficking are individuals who have had their organs taken without their consent, or whose consent was a product of deception, fraud, or coercion. Most commonly, the traffickers are part of criminal networks who profit by selling organs to recipients who are unwilling or unable to wait for legal transplants. Some of the largest known organ trafficking markets include the “Kidney Valley” of Nepal, an organ trafficking ring in Hanoi, Vietnam, and a similar case in an Indonesia to Cambodia organ pipeline.

The practice of “transplant tourism” describes an individual going abroad, outside of their national jurisdiction, to receive a transplant. This practice is often exploitative, as it commonly involves recipients travelling to developing countries where they can illegally purchase organs for cheaper than officially sanctioned transplants.

• Brokers

  • Brokers play a key role in this operation by acting internationally to connect potential buyers and sellers of organs. The broker possesses knowledge about medical professionals and hospitals that facilitate illegal transplants, and often takes on a role as negotiator of prices and fees. Brokers receive the greatest profits, typically more than 50% of the funds paid by the recipient

• Victims/Donors

  • Victims of organ trafficking, commercialization or transplant tourism are most commonly from China, Egypt, India, Iraq, Pakistan and the Philippines, as well as countries in Central and South America and in Eastern Europe. Often, they are men aged 20-40, living in poverty. Victims/donors receive, on average, less than 10% of the funds paid by the recipient, with payments ranging from US$400 to US$30,000. Numerous studies show that those who sell their organs often regret it, as they may experience lingering health issues.  

• Recipient

  • Travelling abroad for organ purchase has been commonly reported among nationals of Australia, Canada, Japan, South Korea, the United States, and countries in the Middle East and Western Europe. Organ recipients typically pay between US$7,300 and US$160,000. Organ recipients are complicit when they do not ensure consensual organ donation or when they offer compensation for the sale of an organ. The absence of informed consent is not just constituted by coercion or manipulation of consent; it also involves being willfully blind or reckless as to how an organ was obtained. 

• Local recruiters/facilitators

  • Recruiters operate locally in comparison to brokers, working to identify specific organ sellers/suppliers in their given area. They are typically paid for each transplant they help facilitate. 

• Medical professionals and local hospitals

  • The organ trade requires collaboration from medical professionals and hospitals to facilitate organ removals and transplants. These actors can be implicated in the direct coordination of trafficking networks or act as contractors to perform operations on behalf of brokers or recruiters. Occasionally, hospitals and their staff unknowingly participate in organ trafficking. 

What laws, policies and regulations currently dictate practices of organ donation and trafficking?

The list below is not exhaustive, especially for national or local regulations. We highlight international policies, regulations and best practices, as well as a few instances of national law. 

• In the United States, the National Organ Transplant Act (NOTA), passed in 1984, makes it a felony to buy or sell human organs.

• Palermo Protocol oversees Trafficking in Persons, which can refer to organ trafficking

• The Declaration of Istanbul is not a legal document, but a declaration that outlines best practices of organ transplantation. It defines transplant tourism as travelling for a transplant, and encourages states to take action in accordance. The authors of this declaration hope medical institutions around the world will sign on to and adhere to it.

• The World Health Organization outlines best practices (urges the prohibition of any compensation for organ donation). 

• The Council of Europe Convention against Trafficking in Human Organs created first legally binding international instrument targeted directly at organ trafficking (Albania, Belgium, Costa Rica, Croatia, Czech Republic, France, Latvia, Malta, Moldova, Montenegro, Norway, Portugal, Slovenia, Spain and Switzerland – 15 states signed as of Jan 2025) The purposes of this document are: “to prevent and combat the trafficking in human organs by providing for the criminalisation of certain acts; to protect the rights of victims of the offences established in accordance with this Convention; [and] to facilitate co-operation at national and international levels on action against the trafficking in human organs.”

• The United Nations General Assembly resolution 71/322, titled Strengthening and promoting effective measures and international cooperation on organ donation and transplantation to prevent and combat trafficking in persons for the purpose of organ removal and trafficking in human organs, was adopted in 2017. It encourages member states to: prosecute and punish illicit activities involving organ trafficking, ratify and accede to the Palermo Protocol, adopt measures in line with the World Health Organization’s guiding principles, and protect victims of trafficking in persons for the intent of organ removal.

How do commercialized organ markets function?

• Iran is the sole country with an official system of commercial organ transplants, offering compensation to living kidney donors. Donors receive between US$2,000 and US$5,000 from the recipient, plus a US$1,200 subsidy from the government and one year of free health care. However, within this legalized framework, most kidney donors still come from poverty, highlighting that concerns about inequality in commercialized organ markets are not without merit. 

While organ trafficking necessarily involves coercion, fraud, force, deception or abuse of power, arguments exist for the commercialization of organ markets, where consenting individuals can sell their organs for profit. The details of this argument, and counter-points against the commercialization of organ donation, are detailed below.