Desperate Americans Buy Kidneys From Peru Poor in Fatal Trade

[Clark]

http://www.bloomberg.com/news/2011-05-12/desperate-americans-buy-kidneys-from-peru-poor-in-fatal-trade.html

Desperate Americans Buy Kidneys From Peru Poor in Fatal Trade
By Michael Smith

Luis Picado’s mother remembers the day her son thought he had won the lottery. He came home to their tin-roofed cinder-block house in a Managua, Nicaragua, slum and said he’d found a way to escape poverty and start a new life in the United States.

An American man had promised to give Picado, a 23-year-old high school dropout who worked as a construction laborer, a job and an apartment in New York if he’d donate one of his kidneys. He jumped at the deal, his mother says.

Three weeks later, in May 2009, Picado came out of surgery at Managua’s Military Hospital, bleeding internally from the artery doctors had severed to remove his kidney, according to medical records. His mother, Elizabeth Tercero, got on her knees next to her son’s bed in the recovery room and prayed, Bloomberg Markets magazine reports in its June issue.

“I told my boy not to worry, that I would take care of him,” Tercero, 49, says. “But it was too late.” Picado bled to death as doctors tried to save him, according to a coroner’s report. “He was always chasing the American dream, and finally, it cost him his life,” she says.

Matthew Ryan, the American man, suffered a similar fate. Ryan, a 68-year-old retired bus company supervisor in New York, died two months after receiving Picado’s kidney in the same hospital.

Nicaraguan postmortem reports cited the transplant as a cause of death for both men. Prosecutors in Managua are now investigating whether anyone broke a Nicaraguan law that prohibits paying a donor for an organ.

Illicit Market

The two men were participants in a growing and illicit market for organ transplants that spans the globe. Every year, about 5,000 gravely ill people from countries including the U.S., Israel and Saudi Arabia pay others to donate an organ, says Francis Delmonico, a Harvard Medical School professor and surgeon. The practice is illegal in every country except Iran, Delmonico says.

Affluent, often desperately ill patients travel to countries such as Egypt, Peru and the Philippines, where poor people sell them their organs. In Latin America, the transplants are usually arranged by unlicensed brokers. They’re performed -- for fees -- by accredited surgeons, some of whom have trained at the world’s leading medical schools.

The global demand for organs far exceeds the available supply. In the U.S., 110,693 people are on waiting lists for organs, and fewer than 15,000 donors are found annually.

Americans who go abroad for illicit transplants can contract infections or HIV from unhealthy donors, posing a public health threat when they return, Delmonico says.

‘Exploit the Patient’

“With all the anxiety in getting a transplant, they exploit the patient,” says Delmonico, who is president-elect of the Montreal-based Transplantation Society, which lobbies governments to crack down on trafficking. “It’s big money.”

The illegal organ trade is the ugly side of the otherwise legal medical tourism industry, in which people travel to other countries for cut-rate hip replacements, tummy tucks and gastric bypasses. The legitimate medical procedures generated about $100 billion in revenue in 2010, according to a report by Deloitte Touche Tohmatsu Ltd.

For decades, wealthy Brazilians, Mexicans and Saudis have gone to U.S. and European hospitals for medical care they couldn’t get at home. In the past decade, that pattern has changed. Hospitals from Puerto Vallarta, Mexico, to Medellin, Colombia, now lure middle-class Americans with promises of high- quality care at a fraction of what it would cost them at home.

Medical tourism company MedToGo LLC, based in Tempe, Arizona, says it will offer kidney transplants in Mexico and Costa Rica for about $50,000, a fifth of the cost in the U.S.

Preying on the Poor

In the illegal organ trade, brokers scour the world’s slums, preying on the poor with promises of easy money and little risk in exchange for a kidney. Inside hospitals, people are injured or killed by botched surgery as doctors place money above ethics, criminal investigators say.

In Colombia, 321 foreigners got transplants from 2005 to 2010, according to the country’s National Health Institute. Juan Lopez, a doctor who oversees Colombia’s organ transplant system as director of the NHI, says many of these surgeries are driven by profit for hospitals, doctors and brokers.

“I don’t want my country to be a Mecca for transplant tourism,” Lopez says. He’s gone to court to try to stop 23 organ transplants for foreigners since 2010, he says.

In Peru, Rafael Peraldo, a taxi driver who’s under investigation for being an organ broker, has plied Lima’s dusty slums since at least 2005, according to five people who say in interviews that they sold kidneys to him.

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