DESPERATELY ill Australians are travelling overseas to buy body organs taken from impoverished people or executed prisoners, according to experts.
In a trend causing alarm among specialists, people who have received organ transplants overseas are turning up in local clinics for follow-up treatment.
Doctors say that the patients involved are putting themselves and their donors at risk, and that they may also be fuelling the use of prisoners and poor people for organ harvesting.
One patient went to a Sydney hospital recently after buying a kidney from a poor donor in the Philippines, The Age has been told. Doctors have grave concerns about the health of the donor and the recipient.
Professor Bruce Pussell, of Sydney's Prince of Wales Hospital, said he believed many Australians had received organs taken from executed prisoners.
Exact numbers are unknown. But his own "small" unit, which treats about 25 transplant patients a year, sees around one patient a year who has bought an organ or received it from an executed prisoner. "If you extrapolate that, it's 4-5% of all transplants in Australia," he said.
Transplant Society of Australia and New Zealand vice-president Frank Ierino said while he had not personally treated anyone who had bought an organ, several had asked him how they could.
The trend is being fuelled by a chronic shortage of donor organs in Australia, where it is illegal to buy or sell organs.
The president of the Hong Kong Society of Transplantation, Ka-foon Chau, believes Australians are travelling to China to get organs from executed prisoners.
While foreign patients are rare in Hong Kong hospitals because of the cost of treatment, she told The Age she had heard that "patients from all over the world — Australia, the USA, Canada — go to China and then back to their country land for follow-up treatment".
Dr Chau's belief that prisoners' organs have been harvested were strengthened this year when China changed its laws so that a donor's consent had to be obtained before their organs were taken.
"Over the past 10 years … about 200 renal patients in Hong Kong have gone to China for a transplant (annually). And (then) this year it dropped to 20 patients," she said.
More recently The Age has reported that the Chinese Medical Association will require its members not to take organs from executed prisoners — even those who have consented.
Dr Chau said Hong Kong doctors felt "uneasy" about the use of organs from Chinese prisoners. "We don't know if they have gotten the consent of the donor, whether the number of executions has been increased (to meet demand) or whether the standard of care is good enough," she said.
Professor Pussell agreed. "You can imagine the sort of thing that might happen," he said. "They'd do the tissue typing, find a prisoner on death row who matches (the patient) and therefore they would schedule the execution earlier."
Even for apparently willing donors, there are problems. "In the Western world if you donate a kidney your chances of a normal life are extremely good, because there is a careful assessment to determine whether the (remaining) kidney is healthy … and we follow donors for life," Professor Pussell said. But this did not happen in poorer countries such as the Philippines.
Many Australians feel tempted to consider the overseas option because of our low rates of organ donation, which are among the lowest in the developed world.
In the US and many parts of western Europe, rates of transplants from the deceased are at least double those in Australia, according to Sharelife Australia.
In March this year, 1784 people were waiting for organ transplants, according to the group Australians Donate. But by the end of August, only 131 people had donated, allowing 435 people to receive transplants.
Bernard Collaery — who represented Falun Gong members when they fought Howard government attempts to stop them demonstrating outside the Chinese embassy in Canberra — said there should be trans-national legislation to prevent organ trafficking.
Mr Collaery, a former ACT attorney-general, said that "in the same way we've legislated to punish those who organise child sex tours, whether they're caught here or overseas", Australia should enact laws that apply both here and overseas to crimes associated with trafficking in illegally acquired organs.
"It's no good saying the mother freely relinquishes her infant when she can't feed it," Mr Collaery said. "In the same way, organs acquired from the impoverished are illegitimate."
But Professor Pussell does not believe legislation against those needing a donation is the way to go, saying the issue is an ethical and moral one, rather than a legal one.