Current Concerns in Transplantation

By Noel, Luc | Bulletin of the World Health Organization, December 2007 | Go to article overview
Save to active project

Current Concerns in Transplantation


Noel, Luc, Bulletin of the World Health Organization


As long as the global supply of tissues, cells and organs for transplant does not meet needs, desperate patients are easy prey for unscrupulous individuals. Yet countries including Spain and the United States of America have shown that it is possible to make progress towards self sufficiency in transplants by meeting these needs with altruistic donations. Achieving national self-sufficiency is not easy. It requires a level of commitment from society that very few countries have been able to garner, but building this commitment arguably costs much less in the long term than relying on the payment of "volunteers"--inevitably the poor and vulnerable.

In contrast to organs, most human tissues and cells destined for transplantation can be processed, preserved and stored, often for long periods. Their transportation can be very easy and shipping across national boundaries is sometimes necessary to best meet patients' needs. Risks of ethical breaches arise at all stages; from consent to donation through to the allocation of transplants, and the clinical care of donors and receipients. Recent cases of cadaveric tissue theft have shown how unethical behaviour in tissue procurement bypasses the safety barriers designed to decrease the risk of transmitting infectious diseases to receipents. (1,2) The international circulation of human cells and tissues may also be an opportunity for hefty profit. Those who wish to profit from this trade do so by taking advantage of both poor people and their need for income, and of wealthy patients' needs and their ability to pay.

The international organ trade is widely referred to as "transplant tourism". This entails cross-border travel by any participant in transplantation (recipients and/or surgeons and/or live donors) for the purpose of obtaining an organ in exchange for cash or goods. The profit motive predominates in this trade, more than the interest of the patients, and care for the live organ donor is secondary or non-existent.

This issue of the Bulletin contains two papers on transplantation: the first is dedicated to the ethical aspects of cell and tissue transplantation, (3) the second is an attempt to produce a picture of the international organ trade. (4)

Both papers are outputs of WHO's consultation process in response to Resolution 57.18 of the 2004 World Health Assembly on updating the 1991 Guiding Principles for Human Organ Transplantation. Resolution 57.18 requested WHO's Director-General to collect global data on all aspects of transplantation--including ethical issues. With the support of the Spanish government, WHO has contributed to a global knowledge base on transplantation designed to document the global situation of legitimate transplantation from official sources in most Member States. (5)

However, there is no such official source of data on transplant tourism. This trade is illegal wherever relevant laws exist. Measuring the extent of this illicit trade is impossible, and Shimazono's paper (4) takes the necessary, but limited, first step of gathering available information in order to form a first estimate. This paper is further limited by its identification of transplant activities from publications and in only two languages. It does not attempt to quantify the activity of concealed organizations and undercover networks which are known to exist.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Current Concerns in Transplantation
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?