Transnational Crime and the Developing World

developed countries is US$20,000, whereas vendors in developing countries receive US$3,000 for the
sale of their kidney, a difference of more than 500 percent.
C. Dynamics
Much of the focus of the illegal organ trade is placed on the vendor and recipient, but there are a variety
of actors that play important roles in perpetrating this crime. A vendor, recipient, and transplant team, as
well as various individuals from the public and private sectors are involved in every transaction; brokers
are also involved in some instances. Table L describes the principal participants involved in the illegal
organ trade.
Table L. Participants in the Illegal Organ Trade
Vendor
Recipient
Broker/Scout
Transplant teams
Public and private
sector services
The individual from whom an organ is harvested. Vendors are customarily from developing
countries and are poor and uneducated.
The individual who purchases an organ/undergoes transplantation. Recipients are typically
middle- and high-income individuals from developed countries or high-income individuals
from developing countries.
The individual who recruits the vendor, recipient, and/or medical professionals. They often
operate in small, specialized syndicates that are well organized and well funded, with
established networks for recruitment and transplantation. They are not necessarily involved in
every transaction, particularly those where the recipient recruits their own vendor.
The surgeon(s), nephrologist(s), anesthesiologist(s), nurse(s), etc. involved in determining
whether the vendor and recipient are a medical match as well as performing the actual
transplantation.
The other actors, including medical services, such as hospitals, transplant centers, and
laboratories, where the transplantation and associated procedures are performed; medical
tourism agencies, some of which coordinate transplant tourism; airlines; law enforcement;
and translators. The participation of some of these actors (e.g., airlines or insurance
companies) does not mean that they are aware of the illegal activity.
The dynamics of the illicit organ trade follow basic economics, with both vendors and recipients being
price takers. Brokers are able to profit off the desperation of vendors and recipients by engaging in
arbitrage; they pay vendors a pittance in comparison to the large fees they charge recipients. They
earn the largest share of the profit and face little risk of detection. 138 Brokers and scouts, by creating
competition among donors, are able to increase their profits as vendors are willing to accept less money
in order to be chosen.
There are four principal models of organ trafficking. The traditional kidney brokerage model sees the
broker recruit the vendor, recipient, and surgeon. The emerging model for kidney transplants sees the
recipient recruit the vendor themselves. 139 Recipient and vendor frequently connect online, through
social media and transplant blog sites, but on the dark web as well. The recipient can often find willing
transplant surgeons by going through agencies or medical centers that cater to medical tourism. These
businesses usually connect patients with medical professionals in foreign countries for legal procedures,
such as plastic surgery or dental work, however some agencies also facilitate illegal transplantations.
Mirroring tactics used in human trafficking, some brokers or recruiters have lured individuals with the
promise of work abroad, only to be forced to sell a kidney upon arrival to their destination. A variation of
this sees a creditor, such as a landlord or smuggler, coerce an individual into selling a kidney in order to
138
Michael Bos, Trafficking in Human Organs (Brussels: Policy Department, Directorate-General for External Policies, European Parliament, 2015), 25,
http://www.europarl.europa.eu/RegData/etudes/STUD/2015/549055/EXPO_STU(2015)549055_EN.pdf.
139
Campbell Fraser, “Human Organ Trafficking: Understanding the Changing Role of Social Media and Dark Web Technologies 2010-2015” (Presentation,
George Mason University, Fairfax, Virginia, January 21, 2016).
Transnational Crime and the Developing World 31