International organisations have detailed steps to be taken for governing organ donation and transplantation in a declaration that aims to oppose transplant commercialism, transplant tourism and organ trafficking.
If taken into practice, these steps could help in ensuring patient safety and prohibiting unethical practices.
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).
According to the Declaration of Istanbul, as unethical practices are an undesirable consequence of the global shortage of organs for transplantation, each country should implement programs to prevent organ failure.
It also said that the countries should provide organs to meet the transplant needs of its residents from donors within its own population. Experts have also suggested that the therapeutic potential of deceased organ donation should also be maximized.
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, said Dr. Francis Delmonico, professor of surgery at Harvard Medical School.
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 in the introduction of the declaration.
Delmonico added that transplant tourists also risk physical harm by unregulated and illegal transplantation.
Participants in the Istanbul Summit have called for transplant professionals to put an end to these activities and to foster safe and ethical practices for both transplant recipients and donors.
The Declaration 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," states the Declaration.
The declaration is appearing in the September issue of the Clinical Journal of the American Society of Nephrology (CJASN).