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Iran: Guardian Council Moves to Make Donor Organs More Available

By Azam Gorgin/Jamshid Zand/Charles Recknagel

Iran this month reversed a long-standing ban on using the organs of dead or brain-dead persons for transplants. The ruling will make it easier for the gravely ill to obtain replacement organs they need to survive. But it is unclear if the step will help reduce an illegal trade in poor people selling their kidneys for transplants through black market brokers. RFE/RL's Azam Gorgin tells the story:

Prague, 20 December 2000 (RFE/RL) -- Iran's constitutional oversight body has decided to allow transplants of organs from the dead and brain-dead to patients, reversing a previous religious ban on the practice.

The decision came in an announcement this month from the Guardian Council approving a bill passed by parliament early this year. The bill was partly intended to enable sick people who have refrained from seeking transplants for religious reasons to now go ahead with the operations.

Previously, the use of corpse donors had been banned under ancient Islamic injunctions against the mutilation of dead bodies. Those injunctions were historically intended to stop warriors from mutilating the bodies of their slain enemies as an insult to relatives.

The Guardian Council ruled that removing organs for transplants does not violate the injunctions so long as the procedure is not intended to offend the deceased. The ruling also permits removing organs from the brain-dead so long as the operation does not lead to their death.

But it is unclear whether the new ruling could help curtail a black market trade which has grown up in Iran due to the previous ban on corpse donors and the shortages of transplant organs which those injunctions caused.

That trade has seen brokers publicly soliciting poor people to sell a kidney, which the broker then resells to patients at prices only the wealthiest can afford. The sums offered by the brokers are reported to have led many would-be donors to stop offering their organs even to close relatives in hopes of selling them at profit instead.

Usually, the brokers post advertisements near state-administered kidney transplant centers. And at times, would-be kidney sellers try to bypass the brokers by posting their own advertisements, too.

RFE/RL's Persian Service correspondent Jamshid Zand recently phoned one would-be kidney seller to learn how the trade works. The dialogue begins with the seller speaking:

"I want to sell my kidney because I have no money." The conversation continues with our correspondent asking the price.

"How much would you sell your kidney for?

"I don't know, it's never happened to me before. About 3,500,000 toomans (around $4,500 at the free-market exchange rate).

"Why have you decided to sell your kidney?"

"I have just come out of prison and I have nothing. And that's the reason."

Other would-be sellers have other reasons, as one Iranian newspaper discovered recently when it published an ad from a private individual seeking a kidney. Respondents included a man who wanted to earn money to start a business, a soldier who wanted to buy a house, and a girl who wanted to continue her college education.

So far, Iranian authorities have done little to crack down on the illegal trade. And some health officials maintain no such trade even exists.

The Islamic Republic's former health minister Iraj Fazel told RFE/RL recently that people can receive rewards for donating kidneys under state-administered programs. But he said that there are no commercial organ brokers.

"It is not true people profit from selling kidneys in Iran because people who donate their kidneys get a reward. The donors and recipients know of each other. There is no selling of kidneys, only donating."

Under a health ministry program, people who donate kidneys legally for operations can receive a reward of 450,000 toomans, or about $570 at the free-market exchange rate. The Iranian daily Dowran Emrouz recently reported that the parliament has approved raising the rate to 1,000,000 toomans, or $1,250.

With the Guardian Council's new ruling that corpse donors can be used for transplants, the supply of badly-needed organs should come into better balance with the numbers of patients.

It remains to be seen whether the greater supply will drive down the price for live donors to a level small enough to stamp out the black market trade.