KEY POINTS:
At least one woman has died as desperate Kiwis spend up to $100,000 on the international black market for organs.
New Zealand has one of the lowest organ donor rates in the world and patients are travelling to China, India and Pakistan for potentially lifesaving transplant operations.
But Auckland kidney specialist Ian Dittmer said they often returned with serious medical complications.
His colleague, Auckland transplant surgeon Stephen Munn, has suggested the Government could pay $5000 to $10,000 to provide an incentive for Kiwi donors and cover their costs.
Dittmer and Munn know of two cases of transplant tourism this year, a woman in her 20s who had a successful kidney transplant in China, and a man in his 20s who went to Pakistan with his mother but cancelled her kidney transplant because he was so appalled by the set-up.
Other known cases include:
A woman who got a kidney in China from an executed prisoner about two years ago.
A middle-aged man who had a kidney transplant in India, only to return with a severely infected wound and a non-functioning kidney.
A woman in her 30s who was infected with hepatitis B from a kidney transplant in India and died of acute liver failure shortly after returning home.
Munn said patients paid $70,000 to $100,000 for organs but warned against the practice, citing Dirty Pretty Things, a film about illegal transplants in London. "People get coerced into giving organs, there's organ trafficking - it's horrendous."
New Zealand's dead donor rate is six per million people, compared with 10.5 in Britain and 33.8 in Spain.
About 570 Kiwis are waiting for a kidney, with another 38 requiring other organs. Last year, there were only 38 dead donors and 62 living donors.
Munn predicted the kidney waiting list could reach 1000 within a decade as obesity-related diabetes continued to rise and people lived longer. Medical advances will reduce the pool of dead donors, he said.
"There will be pressure put on friends and relatives and acquaintances in the future because there's such a big waiting list."
Munn argued the only options were to ration organs or provide a financial incentive for live donors to volunteer.
He pointed to Iran, where live kidney donors were paid by the Government and private organisations and there was no waiting list.
Worldwide, experts are debating whether donors should be reimbursed. In May, an Australian doctor upset his colleagues by suggesting young, healthy Australians should be paid A$50,000 ($60,000) to surrender a kidney for transplant. But Dittmer was worried payment would encourage the poor and desperate to sell their organs.
Transplant campaigner Andy Tookey said he wanted the Government to foot the funeral bill for dead donors as an incentive. Deborah Roche from the Ministry of Health said a new law governing organ transplants prohibited providing "financial or other consideration" for human tissue. This also applied to funeral expenses.
