Transplant Brokers in Israel Lure Desperate Kidney Patients to Costa Rica

[Clark]

http://www.nytimes.com/2014/08/17/world/middleeast/transplant-brokers-in-israel-lure-desperate-kidney-patients-to-costa-rica.html?hp&action=click&pgtype=Homepage&version=LargeMediaHeadlineSumCentered&module=photo-spot-region&region=photo-spot&WT.nav=photo-spot&_r=0

Transplant Brokers in Israel Lure Desperate Kidney Patients to Costa Rica
By KEVIN SACK

Photo: Ophira Dorin traveled from Israel to Costa Rica for a kidney transplant that cost her $175,000. The donor was paid $18,500.

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A broker who trades in human organs might seem a difficult thing to find. But Ms. Dorin’s mother began making inquiries around the hospital where she worked, and in short order the family came up with three names: Avigad Sandler, a former insurance agent long suspected of trafficking; Boris Volfman, a young Ukrainian émigré and Sandler protégé; and Yaacov Dayan, a wily businessman with interests in real estate and marketing.

The men were, The New York Times learned during an investigation of the global organ trade, among the central operators in Israel’s irrepressible underground kidney market. For years, they have pocketed enormous sums for arranging overseas transplants for patients who are paired with foreign donors, court filings and government documents show.

The brokers maintain they operate legally and do not directly help clients buy organs. Dodging international condemnation and tightening enforcement, they have nimbly shifted operations across the globe when any one destination closes its doors.
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Because most people can live with only one kidney, that organ accounts for the vast majority of living-donor transplants. Laparoscopy has made the surgery to remove a kidney fairly routine, although it is not risk-free. Living donors account for about 40 percent of the roughly 80,000 kidney transplants performed worldwide each year, according to the W.H.O.

Patients fortunate enough to find a living donor with the right blood type and antigens can avoid the lengthy wait for an organ from a cadaver. Kidneys from living donors are also preferred because they tend to last longer.
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“He said it was nothing dishonest,” Dr. Montalbert-Smith said in an interview in San José, “that lawyers had written papers, that they are not paid donors. But if a foreigner comes here and the donor doesn’t know him and says he is an altruistic donor, the chance that it is trafficking is very high. I told him, ‘No thanks.’ It wasn’t easy to refuse.”
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The Costa Ricans who provided kidneys to foreigners were mainly men who had not finished high school and were either unemployed or held low-income jobs.
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“It is clear to us that these people sold their bodies for pennies,” Mr. Arenfeld said of the donors. He said that prior arrests had not seemed to deter the brokers, adding, “We see a pattern of behavior that is repeating itself.”