Bootcongres

Background In 2010 a South African hospital plead guilty for allowing its doctors and other employees to conduct over 100 illegal kidney transplants. In 2013 in Kosovo doctors were convicted for participating in 30 illegal transplants. Both cases have a strong connection with Israel. In 2012 and 2013 we travelled to South Africa, Kosovo and Israel to study and compare a) the modus operandi of the criminal networks, and b) the successes and hurdles of authorities in the investigation and prosecution of the networks. This study formed part of the EU-funded HOTT Project on trafficking in human beings for the purpose of organ removal that aims to improve non-legislative responses to the crime. Methods We conducted fieldwork in each country. We performed 25 interviews with police, prosecutors, legal experts, policy-makers, ministry representatives, health inspectors , patients, nephrologists, transplant surgeons, health insurance company representatives, defense attorneys, representatives of international organizations and national transplant coordinators. Interview transcripts were analyzed qualitatively. In addition, we studied case materials, including charge sheets, witness statements, indictments, closing statements and legislation. Results Using sophisticated modes of operation, both trafficking networks successfully conducted illegal transplants in an organized manner. Most of the recipients were of Israeli descent and were charged up to US$120,000 for a transplant. ‘Donors’ were recruited from Romania, the Russian Federation, Brazil, Israel, Kazakhstan and other Eastern European countries. They were (sometimes falsely) promised amounts between US$3,000 and $26,000. Both networks operated for a long time with relative impunity because of legal loopholes and corruption, and were discovered and prosecuted very differently. The local disruption of the criminal networks can be defined as the most important success, while the biggest hurdle in both cases comes down to international collaboration. Conclusion Prosecution of organ trafficking networks is rare. Under the HOTT project, the modus operandi and successes and hurdles in the investigation and prosecution of both cases will be used to develop indicators and recommendations that will benefit countries worldwide in recognizing, investigating and prosecuting organ trafficking.