London, June 14 : Some top surgeons believe that governments across the world should introduce radical reforms to regulate the practice of transplant tourism, which they say is adversely affecting people in developing countries like India and Pakistan.
Professor Maqsood Noorani, former transplant surgeon at The Barts and The London NHS Trust in London, says that the UK government must bring in presumed consent to organ donation, or allow a controlled donor compensation programme for unrelated live donors.
He points out that most of the live unrelated donors from countries like Pakistan happen to be desperately poor, and that organs coming from them are transplanted into the rich.
Writing in the British Medical Journal about his first hand experience as part of a transplant team trying to save the lives of British patients who have suffered complications after buying a kidney from a live donor in Pakistan, Noorani revealed that the practice also exploited women who constitute 95 per cent of related live donors.
In the male dominated society of Pakistan, he added, women often had no say over what happened to them.
Noorani also insisted that governments of rich countries should put pressure on Pakistan to discourage patients from travelling for organ transplants, and become self-sufficient themselves by introducing a presumed consent or controlled donor compensation system.
Professor Leigh Turner from McGill University in Canada says that most donors from India, Pakistan, and the Philippines receive less than 2000 dollars, and that the only winners are the organ brokers and transplant surgeons who can charge recipients more than 80 000 dollars.
He also says that commercial transplantation carries huge risks for the organ recipients, and that inadequate screening and testing has resulted in cases of HIV, hepatitis, malaria and tuberculosis.
Arthur Matas, Professor of Surgery at the University of Minnesota, insists that a regulated compensation system in the Western world would increase the number of available organs.
He believes that such a system would provide strict control and limit harm by allowing every candidate an opportunity for transplant, full donor evaluation, informed consent, long term health follow-up, with payment managed by the government or insurance companies, and the banning of any other commercialisation.
Jeremy Chapman of the Centre for Transplant and Renal Research in Sydney, however, believes that the idea of the regulated market is a myth, for people would prefer a stranger rather than a family member to take the risk even when the government is willing to pay for a kidney.
The reality of regulated organ purchase will be a reduction in organ donation, and the destruction of kidney, heart, lung, liver, and pancreas transplantation, he says.