Luis Picado’s mother remembers the day her son thought he had won the lottery. He came home to their tin-roofed cinder-block house in a Managua, Nicaragua, slum and said he’d found a way to escape poverty and start a new life in the United States.
An American man had promised to give Picado, a 23-year-old high school dropout and construction worker, a job and an apartment in New York if he’d donate one of his kidneys. He jumped at the deal, his mother says.
Three weeks later, in May 2009, Picado came out of surgery at Managua’s Military Hospital, bleeding internally from the artery that doctors had severed to remove his kidney, according to medical records. His mother, Elisabeth Tercero, got on her knees next to her son’s bed in the recovery room and prayed.
“I told my boy not to worry, that I would take care of him,” Tercero, 49, says. “But it was too late.” Picado bled to death as doctors tried to save him, according to a coroner’s report. “He was always chasing the American dream,” she said, “and finally, it cost him his life.”
Matthew Ryan, the American man, suffered a similar fate. Ryan, a 68-year-old retired bus company supervisor in New York, died two months after receiving Picado’s kidney in the same hospital.
Nicaraguan post-mortem reports cited the transplant as a cause of death for both men. Prosecutors in Managua are investigating whether anyone broke a Nicaraguan law that prohibits paying a donor for an organ.
Growing, illicit market
The two men were participants in a growing and illicit market for organ transplants that spans the globe. Every year, about 5,000 gravely ill people from countries including the United States, Israel and Saudi Arabia pay others to donate an organ, says Francis Delmonico, a Harvard Medical School professor. The practice is illegal in every country except Iran, Delmonico says.
Affluent, often desperately ill patients travel to countries such as Egypt, Peru and the Philippines, where poor people sell them their organs. In Latin America, the transplants are usually arranged by unlicensed brokers. They’re performed — for fees — by accredited surgeons, some of whom have trained at the world’s leading medical schools.
The global demand for organs far exceeds the supply. The U.S. waiting list for organs has 110,693 people, and fewer than 15,000 donors are found annually.
Americans who go abroad for illicit transplants can contract infections or HIV from unhealthy donors, posing a public health threat when they return, Delmonico says.
“With all the anxiety in getting a transplant, they exploit the patient,” says Delmonico, who is president-elect of the Montreal-based Transplantation Society, which lobbies governments to crack down on trafficking. “It’s big money.”
The illegal organ trade is the ugly side of the otherwise legal medical tourism industry, in which people travel to other countries for cut-rate hip replacements, tummy tucks and gastric bypasses. The legitimate medical procedures generated about $100 billion in revenue in 2010, according to Deloitte Touche Tohmatsu.
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