For decades India has been known as the 'great organ bazaar' and has become one of the largest centres for kidney transplants in the world. Dr. Sanjay Nagral traces the history of the organ market and the lack of medical ethics that has made it a thriving business.
Indian public life is riddled with scandals. One such scandal that distinguishes itself by the way it repeats itself with amazing regularity and hits the headline every few years is the scandal of the Indian kidney bazaar, as crudely described at some stage in its history. The desperation, ingenuity and collusion of the players involved have made India a hot destination. The trade shifts from one city to another as if in planned rotation. A few years back it was Noida, Amritsar, Mumbai and the latest expose comes from Delhi, where leading doctors from reputed hospitals were arrested for their involvement in an organised racket. Most of us are aware of the classic ingredients of this plot when it is exposed every few years; desperate (and often rich) patients, organized gangs of middlemen luring poor and gullible individuals and 'reputed' and 'successful' doctors and institutions feigning ignorance when raided and arrested.
To understand the issues surrounding this trade, it is essential to look at the background of organ transplantation. Transplantation is one of the most spectacular achievements of modern medical science. With the first successful human kidney transplanted between two identical twins in 1954 by surgeons at the Brigham and Women's hospital in Boston, the field of transplantation exploded. Medical advances have contributed tremendously to its success ratio and have led to a significant increase in the number of transplants being performed. Around 50,000 such transplants are performed annually. The management of end-stage disease of various organs like kidney, liver and heart has thus undergone a paradigm shift. Transplantation is no longer regarded as experimental but established standard therapy by WHO.