The American Society of Transplantation (AST) supports the many initiatives that have been undertaken to promote both deceased and living donor organ donation within the United States. Organ donation in the United States requires explicit permission to donate, most frequently given when seeking a driver’s license, in an advanced directive, or by a surrogate with the authority to make this decision in the case of deceased donors. Despite these initiatives, each year the number of patients added to the waitlist for an organ transplant far exceeds the number receiving a transplant. This has resulted in increased waiting times and increased numbers of deaths on the waiting list. This has also led some individuals to travel abroad for the purpose of obtaining a transplant.
The following definitions are broadly used to define transplant tourism, trafficking of persons for the purpose of organ removal and organ trafficking1:
- Travel for transplantation is the movement of persons across borders for transplantation purposes. Travel for transplantation becomes transplant tourism if it involves trafficking in persons for the purpose of organ removal or trafficking in human organs, or if the resources (organs, professionals, and transplant centers) devoted to providing transplants to non-resident patients undermine the country's ability to provide transplant services for its own population.
- Trafficking in persons for the purpose of organ removal, defined as the recruitment, transportation, transfer, harboring, or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability, or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of the removal of organs.
- Organ trafficking, defined as the removal of organs from living or deceased donors without valid consent or authorization or in exchange for financial gain or comparable advantage to the donor and/or a third person.
Our Position:
- Trafficking in persons for the purpose of organ removal, organ trafficking and transplant tourism lead to significant and unacceptable human rights violations and are condemned by the AST. These practices lead to the exploitation of vulnerable persons who are the source of these organs, and the exploitation of vulnerable patients in need of lifesaving 1 The Declaration of Istanbul on Organ Trafficking and Transplant Tourism (2018 Edition). Transplantation 103(2):p 218-219, February 2019. | DOI: 10.1097/TP.0000000000002540 organ transplants who frequently suffer serious adverse health outcomes including death as a result of these unregulated, illegal transplants.
- Trainees must be aware that these issues may exist in their countries and practice ethically.
- Transplant journals must recognize and have policies to deal with research data derived from donors or recipients that have partaken in organ trafficking.
- The global transplant community must work together to prevent trafficking and exploitation of donors and recipients.
Approved by the AST Board of Directors on February 8, 2023
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