Your Money Or Your Life: The Kidney Trade

Organ Sales For Transplants Flourish

Inside a Peruvian operating room, a patient has just sold one of her kidneys for $18,000. The buyer is Alex Hall, a wealthy California businessman who took extraordinary steps to save his life.

If he had done this in the United States, Hall might be in jail, reports Correspondent Peter Van Sant. In a six-month investigation, 48 Hours has discovered a flourishing kidney marketplace never before revealed to the outside world. It's based in Lima, Peru.

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Hall's story is similar to that of a growing number of Americans who need a kidney and are willing to pay almost anything and go anywhere to get one. It began in January 1999, when Hall's kidneys failed.

"I remember thinking, 'This just can't be happening to me,'" Hall says. He had a loving family, a thriving food import business and an active lifestyle, but years of untreated hypertension caused his kidneys to fail.

"I couldn't concentrate at work, I couldn't concentrate at home. It completely controls your life," he explains.

Hall and his wife, Maria, prepared for the worst. His Los Angeles doctor said he'd have to wait years for a transplant and put Hall on dialysis three days a week to cleanse his blood.

"That first night, I remember driving home and I lost it emotionally," Hall says. "Thinking this is not something I can contemplate for the rest of my life. You're strapped to a machine. It's something that will give you a life, but what quality of life is that?"

That's when Alex's wife stepped in. She is from Peru and had heard of a transplant team in Lima that had a list of people willing to sell a kidney.

"When I went to Peru, I interviewed this team of doctors. I was very impressed with them," Maria Hall says.

Days later, he had a donor – a single mom with financial problems. With everything in place, Hall flew to Lima two years ago. The surgical team in Peru videotaped the entire two-hour operation.

Both Hall and the seller had a complete recovery, the surgical team said. To this day, Hall has never met her, but he has a letter she sent him before leaving the hospital in which, he says, she wishes him the best and describes what the money has meant to her.

To people who believe what he did was unethical, Hall says, "I can understand their concern. But my answer is as follows: unless they've walked in my shoes and seen what I've seen for my future, do not give me your opinion."

In all, the kidney surgery and 30 days of post-operative cost $60,000.

48 Hours also looked into another part of the kidney trade in Peru.
Dr. Bolivar Escobedo provides everything from dialysis to Lima's finest hotels to hospitals with two transplant teams and 16 surgeons.

Escobedo, a native of Peru who received some of his medical training in the U.S. and once had a practice in St. Luis, is Peru's most famous plastic surgeon. Seven days a week, he stars in his own half-hour TV infomercial. Though no longer licensed in the U.S., he remains an American citizen.

Escobedo last year shattered the silence about the buying and selling of kidneys in Peru, which has been going on quietly for years. He took an ad out in USA Today looking for Americans in need of a kidney. He also created the international kidney transplant center, which even has its own Web site.

Escobedo doesn't perform any of the surgeries himself. But his surgical team includes the men who operated on Alex Hall two years ago.

Current costs range from $100,000 to $145,000. An immediate $25,000 down payment is required. Cash is preferred. Credit cards are welcome.

In the past, American health insurance has paid for part of it.

"We can fill the insurance paper for them," Escobedo says. "Our hospitals are fully licensed. So therefore, they can recover the money from the insurance company."

The buying and selling of kidneys has been illegal in Peru for more than a year. But Escobedo says the authorities don't prosecute.

"These people are not doing anything wrong," he says. "They are giving life to somebody."

To make it all work, Escobedo needs people willing to sell a kidney, and in Peru, he says, he has more than 200 healthy people already screened and ready to sell their kidneys.

"That's why I can tell anybody, 'You can get a kidney in 48 hours.' And they will, the doctor says.

Escobedo finds donors in desperately poor neighborhoods where an offer of thousands of dollars is seen as a godsend. One donor, Victor Gonzales, told 48 Hours, "I paid my debts, I cured my children. The money was the solution for my troubles."

But the majority of donors, says Nancy Scheper-Hughes, director of Organs Watch, an international group that monitors the sale of human organs and the people who sell them, "have medical problems, deeply resent what they did, and often feel tricked."

After a two-month search, 48 Hours found Hall's donor in a town in the Andes mountains. She would not let camera crews take her picture or use her real name. Through an interpreter, she told a 48 Hours producer "now she has a problem of her body. She does not feel psychologically well…she feels forgotten."

Says Schepper-Hughes: "We don't want to turn the poor people of the world into bags of spare parts that I or you, a person who has more resources or money, can simply prey upon. It's morally unacceptable to do that."

As part of its investigation, 48 Hours discovered evidence that the international organ trade was happening in this country as well. '

A doctor in Israel, Michael Friedlander, says he has seen at least 10 patients who have come back from the U. S. after these tyes of transactions and they have been treated in some top hospitals.

One of Israel's top kidney specialists, Friedlander says his patients tell him American hospitals have a "don't ask, don't tell "policy. His patients have simply pretended a donor is a friend or distant relative.

One man from Georgia is part of a new breed of kidney seller, offering his kidney on the Internet because he is, in his own words, "about as broke as anybody can get." His asking price: $250,000."

"Everyone else is benefiting, and the donor is actually giving up part of his body, and he's not supposed to benefit? I find that very strange indeed," Friedlander says.

Friedlander believes people like the man in Georgia should be allowed to sell a kidney in a fully regulated transplant center. He's talking about a handful of hospitals in the world where price and quality of medical care would be tightly controlled.

Even transplant watchdog Nancy Scheper-Hughes cautiously approves. " I think it would be all right to have some kind of test program and see, and then just study it."

Organ sales remain a federal offense in the U.S., but there's never been a prosecution. So although the man from Georgia is no longer selling his kidney, dozens of others like him remain on the Internet, waiting for a buyer.
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