RUMORS OF INTERNATIONAL ORGAN SALES RAISE FEARS.

Byline: Donna Alvarado Knight-Ridder Tribune News Wire

In the organ bazaars of India, a starving woman's kidney can command up to $10,000 from a Middle Eastern magnate who could die without it. In some South American morgues, says one researcher, corneas are stolen from cadavers.

Despite efforts to stop it, an international traffic in body parts flourishes with the desperately poor of some countries selling their organs to those rich - and rash - enough to buy them.

Given the life-and-death stakes, the temptation to bargain has become so strong worldwide it overrides cultural taboos and even laws.

``The exchanges tend to be south-to-north, poor-to-rich,'' said Nancy Scheper-Hughes, a medical anthropologist at the University of California at Berkeley. ``I don't think it's a small practice. There are dozens of clinics in Bombay where it's happening. There are suggestions it's happening in parts of Southeast Asia and Korea.''

But the allegations have riled representatives from the U.S. transplant donor network, who say such reports are more fiction than fact.

``Stories about organ trafficking hurt the thousands of people in need of transplants,'' said Mary Ann Wirtz, a spokeswoman for the United Network for Organ Sharing in Richmond, Va. ``Stories like that keep people from becoming donors because they feed misunderstanding.''

Overall, one person dies every three hours in the United States without getting a transplant.

There are about 45,000 people in the United States awaiting transplants of various kinds. Even more can't get on a waiting list because they are considered too old or otherwise unsuitable.

The odds are even worse in many parts of the world where there are no organized national donor distribution systems. Much of the body-organ commerce in India, for example, is linked to wealthy Arabs in Persian Gulf states or the affluent of Southeast Asia, where there are religious and cultural taboos against donating body organs even after death.

There are no documented cases of any wealthy U.S. residents traveling abroad to buy organ transplants, Scheper-Hughes and others say. But given the plight of people who may be at the bottom of a waiting list - or even unable to get on one - the temptation could exist.

``Most of the commerce in organs is done elsewhere, but it will increasingly impact people in the United States,'' Scheper-Hughes said.

She and others are careful to point out that rumors circulating in Central America that people have been kidnapped and their body organs stolen, particularly by U.S. visitors, have not been proven. But such rumors may be fueled by understandable fears of the poor in countries previously ruled by military regimes where political and human rights were fragile.

And while kidnapping may not have occurred, other abuses do. ``In countries . . . such as Argentina and Chile . . . there are practices occurring in hospitals and morgues where they do in fact take cadaveric donors without consent,'' Scheper-Hughes said. Heart valves and corneas are most often taken without permission, she said.

Even in the United States, rumors of stolen body parts circulate occasionally. Experts say such rumors are ``urban legends'' that, while not true, reveal a lot about society's uneasiness with transplantation technology.

One legend heard commonly by transplant networks, for example, concerns men who travel to Las Vegas for gambling, spend the night in a hotel with a prostitute and wake up with a kidney missing.

``I answer at least one question a week about this,'' sighed Carolyn Berry, public affairs manager for the California Transplant Donor Network. ``When you ask them for the source, they never say.''

Such a scenario is nearly impossible, she said, because removing a kidney is a delicate operation that can't be done in a hotel. But the story probably expresses society's worry over the larger issues.

``Medical technology has far surpassed our emotional ability to deal with this,'' Berry said. ``You have a tremendous amount of uneasiness.''

In areas where cultural attitudes differ dramatically from the United States, the sale of a body organ may not provoke the criticism it might here. At a meeting held last year in Italy on the ethics of selling body organs, Scheper-Hughes said, ``some of the surgeons felt the problem was regulating the sale, not forbidding the sale.''

Some have argued, for example, that selling organs is an ethical alternative to letting people die from lack of donations. Since each person is born with two kidneys but can live on just one, selling a kidney does not necessarily harm health and can lift people from extreme poverty.

But Scheper-Hughes is concerned that such a choice is not free when people otherwise face utter deprivation. ``There is a gruesome dimension to people who are already poor, already with poor access to medical care, sacrificing what dignity and health they have,'' she said.

``Can you have informed consent in extreme poverty, when doctors take out newspaper ads offering thousands of dollars?''