Levy Izhak Rosenbaum considered himself a matchmaker, but not the kind you might expect.
In October 2011, the 60-year-old Brooklyn man admitted to brokering the illegal sale of three kidney transplants, purchasing the organs from economically desperate people in Israel for as little as $10,000 a piece, and then selling them to sick patients in America for more than $100,000 each.
Rosenbaum’s lawyers attempted to portray their client as someone offering a life-saving service. But organ selling is illegal, and for his crime Rosenbaum was sentenced to two and a half years in prison, in what was America’s first federal conviction for illegal organ profiteering. He was released in 2014.
But according to experts in the field, Rosenbaum’s case isn’t an isolated incident. His crime barely scratches the surface of a massive underworld of organ trafficking.
“It’s happening in almost every country, all over the world,” says Monir Moniruzzaman, a professor of anthropology at Michigan State University and an expert in illegal organ trafficking. “And it’s becoming more prevalent.”
The Fiction of Horror Movies, and the Horror of Real Life
When laypeople imagine an illegally trafficked organ, they might start with the image of a drugged victim waking up in a bathtub full of ice, stiches running down their torso. But in the real world, organ trafficking almost never involves that kind of surreptitious surgery.
“It’s a complex process,” explains Moniruzzaman. “Tissue typing has to be matched. Papers are forged. Recipients and sellers will have forged passports, claiming that they are family members. And it’s [often] happening in established medical centers.”
The transplants of Rosenbaum’s illegally obtained kidneys took place at top U.S. hospitals, including the Albert Einstein Medical Center in Philadelphia. A physician and a vice president at the hospital testified in Rosenbaum’s trial that he always presented himself as a legitimate facilitator of donor matches and provided proper paperwork.
The true horror of organ trafficking is the desperation of the sellers, and their subsequent exploitation at the hands of the brokers.
Moniruzzaman explains that many organ sellers are impoverished and coerced into their organ sale by those to whom they’re indebted. And because the sellers are in such desperate straits, they often sell without receiving money up front. In his research, Moniruzzaman found that more than 80 percent of organ sellers don’t receive the payment they were promised.
As a result, the sellers often find themselves in a worse situation than the one they were in before giving up an organ. And even in situations when sellers are paid in full, their lives don’t markedly improve.
“It’s a vicious trap,” Moniruzzaman says. “The money runs out in a couple of months…and they can’t go back to physically demanding jobs. This is not a way to live.”
Adding to the horror: the scale of the problem. In a March 2007 report, the World Health Organization estimated that 5 to 10 percent of kidney transplants used illegal organs procured via such trafficking. That number, Moniruzzaman says, has only gotten worse in the years since.
“It’s hidden underground, so it’s very hard to capture the extent of it…but that number is an underestimation.”
How Much Illegal Organs Cost, and Which Ones Are Most Popular
While cadavers in morgues are occasionally illegally raided for organs, Moniruzzaman says organs illegally trafficked from the dead only make up a fraction of total illegal organ sales. The exploitation of living sellers is far more pervasive.
As such, most illegal harvesting centers around organs that people can survive without. Of those, the kidney is the most commonly sold.
According to Moniruzzaman, the price of kidneys varies from country to country. But a seller in India or Bangladesh—where he’s done most of his research—can expect to make between $2,000 and $2,500 when donating their kidney.
The recipient, in turn, pays far more than that to the broker—usually around $20,000. In addition to the broker’s fee (which Moniruzzaman says is “absolutely” higher than the amount the organ seller earns), that money covers medical testing and transportation costs. The procedure itself is not included, and will cost thousands more.
Another organ that’s become more commonly sold in recent years, Moniruzzaman says, is the liver lobe (a portion of a liver). In India and Bangladesh, a liver lobe will earn the seller in the neighborhood of $5,000. In turn, the recipient pays around $40,000 for the organ.
Organ Trafficking and COVID-19
Like most businesses in the world, organ trafficking was disrupted by the COVID-19 pandemic. That’s because many of the transplant operations necessitated bringing together buyers and sellers from different countries, with the procedures often conducted together in the same hospital in yet another country. Because the pandemic brought international travel to a standstill, organ trafficking became even more complicated.
But COVID-19 has also wrought economic hardship. Sources of income dried up without notice, disproportionately affecting the world’s most economically vulnerable. As such, there was a surge of newly desperate people willing to part ways with their organs for cash.
How to End Organ Trafficking
All of this points to a seemingly inescapable black-market economy—one where some are so poor that that they’re willing to give up their organs, others are so sick they’re willing to buy organs procured illegally and others are eager to profiteer as intermediaries.
According to Moniruzzaman, the solution lies in meeting the organ demand, which requires both better policies around organ donations and more medical breakthroughs.
“There’s a serious organ shortage in the world,” he explains. “We should be recycling more body parts… Bioengineering can be part of the solution, too. There’s no breakthrough yet, but these are our alternative ways forward.”
Staying the course, he says, is simply too grim a thought.
“Many of these donors live in very poor conditions—often in slums. They don’t get post-operative care. And they’re selling body parts for their own survival. This whole situation is inhuman.”