All countries should take steps to govern organ donation and
transplantation, thereby ensuring patient safety and prohibiting
unethical practices, according to an article appearing in the
September 2008 issue of the Clinical Journal of the American Society
of Nephrology (CJASN). The document is a consensus of more than 150
representatives of scientific and medical bodies from around the
world, government officials, social scientists, and ethicists, who met
in Istanbul, Turkey, this spring.
Unethical practices related to transplantation include organ
trafficking (the illicit sale of human organs), transplant
commercialism (when an organ is treated as a commodity), and
transplant tourism (when organs given to patients from outside a
country undermine the country's ability to provide organs for its own
population). The Declaration of Istanbul states that because unethical
practices are an undesirable consequence of the global shortage of
organs for transplantation, each country should implement programs to
prevent organ failure and should provide organs to meet the transplant
needs of its residents from donors within its own population. The
therapeutic potential of deceased organ donation should also be
maximized.
In an introduction to the Declaration, Dr. Francis Delmonico,
professor of surgery at Harvard Medical School, emeritus professor of
renal transplantation at the Massachusetts General Hospital in Boston,
and the Director of Medical Affairs at The Transplantation Society
(TTS), noted that with the increasing use of the Internet and the
willingness of patients in rich countries to travel and purchase
organs, organ trafficking and transplant tourism have become global
problems. Through these practices, which target vulnerable populations
in resource-poor countries, "the poor who sell their organs are being
exploited, whether by richer people within their own countries or by
transplant tourists from abroad," he wrote. Dr. Delmonico added that
transplant tourists also risk physical harm by unregulated and illegal
transplantation.
Participants in the Istanbul Summit urge transplant professionals to
put an end to these activities and to foster safe and ethical
practices for both transplant recipients and donors. The Declaration
outlines a number of steps that can help increase deceased organ
donation and ensure the protection and safety of living donors. It
will be submitted to professional organizations and to the health
authorities of all countries for consideration. "The legacy of
transplantation must not be the impoverished victims of organ
trafficking and transplant tourism but rather a celebration of the
gift of health by one individual to another," the Declaration states.
The American Society of Nephrology (ASN) endorses The Declaration of
Istanbul on Organ Trafficking and Transplant Tourism. ASN stands with
The Transplantation Society, the International Society of Nephrology,
and other organizations in condemning these practices.
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The article, entitled "The Declaration of Istanbul on Organ
Trafficking and Transplant Tourism," will appear online at
http://cjasn.asnjournals.org/ on Wednesday, August 13, 2008, and in
the September 2008 print issue of CJASN.
ASN is a not-for-profit organization of 11,000 physicians and
scientists dedicated to the study of nephrology and committed to
providing a forum for the promulgation of information regarding the
latest research and clinical findings on kidney diseases. ASN
publishes CJASN, the Journal of the American Society of Nephrology
(JASN), and the Nephrology Self-Assessment Program (NephSAP). In
January 2009, the Society will launch ASN Kidney News, a newsmagazine
for nephrologists, scientists, allied health professionals, and staff.