Black Market for Organ Sales in Iran; Dr. Saidi Firouzabadi: Rooted in Law and Religion

Alongside a report about some Iranians traveling to neighboring countries to sell their organs, Dr. Reza Saidi Firouzabadi, head of the organ transplant department at the State University of New York, told Voice of America that as long as the buying and selling of organs is legally and religiously permissible, this issue will persist. The Tehran-based newspaper 'Jahan San'at' reported that kidneys, bone marrow, a quarter of the liver, and any other transplantable organ from a living person can be bought and sold in the black market for organ donation, ranging from 100 million to 1 billion tomans. Although the buying and selling of organs is considered a crime in Iran, paying money for 'donating' an organ is legal and referred to as a 'gift.' Last year, the Iranian Kidney Association set the amount for a 'gift for a kidney' at 80 million tomans. 'Jahan San'at' notes that the cost of kidney buying and selling in Iran fluctuates between 500 million to 1 billion tomans at the beginning of the year. This price difference, compared to the 'legal' amount given to the donor, increasingly drives individuals towards brokers. The practice of kidney buying and selling in Iran has a long history. Dr. Reza Saidi states that after the revolution and the challenges in accessing dialysis, a group of surgeons initiated live kidney transplants, and to prevent brokering, the government at that time decided to pay 1 million tomans to donors. He further explains that since then, Shia scholars have endorsed this issue, with many directly referencing organ buying and selling in their fatwas, making it legal to receive money for organ donation. Dr. Saidi mentions that although a rate for organ receipt was always announced based on inflation, the majority of the money exchanged depended on negotiations between the recipient and the donor. He states: 'Other countries have made organ buying and selling illegal, and Iran is the only country where it is legally and religiously permissible.' He emphasized that 'as long as there is a law for the buying and selling of organs, this story will continue.' In recent years, the sale of organs in Iran has extended to hearts, lungs, and corneas. This buying and selling occurs within a legal framework according to principles; for example, individuals register with the Kidney Patients Support Association, and through this, communication between the recipient and donor begins, with negotiations on the matter. The payment to donors is referred to as a 'gift.' The head of the organ transplant department at the State University of New York states: 'Due to poverty, inflation, and unemployment, the rates of organ buying and selling are increasing, and many go to neighboring countries to sell their organs, and this issue will continue until serious actions are taken.' Dr. Saidi Firouzabadi explains that in many countries, organ transplants are performed from patients who have suffered brain death, with only kidney and liver transplants occurring from living individuals. He said: 'In Iran, investment and cultural work must be done on the subject of organ transplants after death so that more people whose loved ones have suffered brain death can donate their organs.' According to the head of the Iranian Organ Donation Association, over 25,000 people are on the organ transplant waiting list. Katayoun Najafizadeh stated that the organ donation rate during the COVID-19 pandemic dropped from 14% to 7%, and the deaths of those on the transplant waiting list, which were previously 7 to 10 people a day, likely doubled. In July 2022, Amir Hossein Alirezaei, head of the Transplant Management Center and Disease Treatment of the Iranian Ministry of Health, announced that there are 3,000 brain deaths eligible for donation annually in the country, of which only 1,000 lead to donations. 'Jahan San'at' reported that every two to three hours, a patient on the transplant waiting list loses their life. The article also discusses the legality of kidney sales and the fight against organ sales in Afghanistan, where a commission for organ transplants is being established.