The development of the Declaration of Istanbul on Organ Trafficking and Transplant Tourism

In this issue of Nephrology Dialysis and Transplantation, theDeclarationofIstanbulonOrganTraffickingandTransplant Tourism is presented from a multicultural representation of the international community as a resolve to combat unethicalpracticesthathavebeenlongstanding.Organtrafficking, transplant tourism and transplant commercialism, which threaten to undermine the nobility of transplantation worldwide, became the subject of a summit convened in Istanbul from 30 April to 1 May 2008 by The Transplantation Society (TTS) and the International Society of Nephrology (ISN). The result of these deliberations was the Istanbul Declaration on Organ Trafficking and Transplant Tourism. The initial text of the Declaration was prepared by a multicultural Steering Committee, which issued the invitations to medical and scientific professionals, representatives of governmental and social agencies, social scientists, legal scholars and ethicist to participate. None of the 152 participantsfrom78countrieswaspolledwithrespecttohis orheropinion,practiceorphilosophypriortoselection.The consensusachievedattheIstanbulSummitwasremarkable. ThedevelopmentoftheIstanbulSummitandDeclaration was derived from a direction by the World Health Assembly in 2004 when it adopted resolution WHA57.18 urging member states: ‘to take measures to protect the poorest and vulnerable groups from transplant tourism and the sale of tissues and organs, including attention tothe wider problem ofinternationaltraffickinginhumantissuesandorgans’.As aconsequence ofthewidespreadshortageoforgansandthe increasing ease of internet communication, organ trafficking and transplant tourism have become global problems accounting for ∼10% of organ transplants that are performed annually around the world. Vulnerable populations (suchasilliterateandimpoverishedpersons,undocumented immigrants, prisoners and political or economic refugees) in resource-poor countries have been a major source of organs for rich patient-tourists who are prepared to travel and can afford to purchase organs. Although the WHA 2004 resolution was unambiguous in its objection to trafficking and transplant tourism, a comprehensive description of these unethicalpractices was still needed. Organ trafficking, transplant tourism and transplant commercialism are now comprehensively defined by