Doctor (illustration)
Doctor (illustration) Photo: iStock

How much does a kidney cost in Iran?

Roughly $4,500, according to current market values.

Iran has had a legal organ market since 1988, which officials tout as beneficial - Iran's kidney wait-lists have been reduced to near-nil, and brisk business pervades. Nearly 55 percents of Irans 2,700 annual kidney transplants come from live donors. Some 25,000 people seek dialysis each year, but most don't apply for a kidney transplant - either due to health, or age.

If someone needs a kidney in Iran, they are referred to the Dialysis and Transplant Patients Association, a matchmaker body for kidney donors and recipients. When a healthy, adult, donor match is found, usually around six months into the search, the negotiations start. An unpaid government broker manages the transaction, usually settling at around a $4,500 payment from the recipient to the donor, or from whatever charity is sponsoring the kidney. The government pays for the surgeries, and the donor gets health coverage for at least a year, plus reduced health-coverage rates for several years afterward in government hospitals.

"Some donors have financial motivations. We can't say they don't. If (those donors) didn't have financial motives, they wouldn't ... donate a kidney," Hashem Ghasemi, the head of the patient-run Dialysis and Transplant Patients Association of Iran, told The Associated Press. "And some people just have charitable motivations."

To prevent a black market from springing up, the transactions are handled and arranged by non-profit groups, who hold the money in escrow until after the surgery. Iran's Health Department must approve every surgery. Iran has also forbidden a kind of "medical tourism," where foreigners come to take part in the program, departing with Iranian live-donor kidneys.

The US, along with many other countries, banned organ sales in 1984, out of fear that unscrupulous brokers would take advantage of desperate or needy people who have body parts to spare. Experts are also concerned that selling kidneys would effectively block poorer people from receiving life-saving medical care.

In Iran, there are definitely some who use their kidneys as "back-pocket cash."

'I am here because if I don't get the money my entire life will be ruined,' said a debtor to the Associated Press. The man was waiting in the hospital to give one of his kidneys, and only agreed to speak on condition of anonymity for fear of ruining his professional image. "My life and my public face are in danger. This has driven me to do this."

In the US alone, more than 100,000 people are waiting for kidney transplants. The average wait time for a kidney transplant stands at 3.6 years. Last year, 17, 878 transplants were made in the US, while 4,481 people died while waiting.

Similar statistics drive a brisk black market in organ transplants around the world. The World Health Organization estimates that black-market kidney transfers account for five percent of such surgeries, though they admit that such numbers are only a guess. A kidney seller in Israel will make an estimated $10,000 on the illegal sale, though there are difficult-to-track reports of kidney thievery and double-crossing all over the world. In the Israel example, a kidney buyer would pay around $130,000 to get a black market kidney - meaning a more than ten-fold profit for the brokers, a high incentive.

Human beings need only one kidney to live, and the gift of life can mean the world for someone suffering kidney failure. As people continue to die on wait lists, while others open themselves to exploitation on the black market, an open, regulated market like Iran's may yet become the future of organ exchange.