Abstract
Kidney transplantation has been practiced in Indonesia by hundreds of patients with End-Stage Renal Disease (ESRD) and has been successful. Kidney transplant activity is considered legal as long as it does not contain elements of trading. Although buying and selling kidneys is considered a crime, there were more than 100 cases of covert kidney sales in Indonesia between 2015-2021. This crime must be eradicated by the Indonesian government, and in order for an effective eradication policy to be based on a study of the causes of people selling their kidneys, using rational choice theory as a theoretical and practical criminological theory is adequate. Based on the results of a study based on rational choice theory, people sell kidneys because they are based on self-assessment, and are always oriented towards the goal of getting money easily, quickly, and a lot. Kidney sellers use 3 criteria in selling kidneys, namely (a) selling kidneys is a preference and occupies the highest hierarchy in the calculation because it is financially profitable, (b) selling kidneys is safer from all risks and can maximize utility, (c) selling kidneys can be beneficial, easy to do, satisfying, and fun.
 
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Highlights
Since 1977, Indonesia has used kidney transplantation as the last treatment option for patients with end-stage renal disease (ESRD), with a total of 629 transplants, which were carried out by 12 kidney transplant canter hospitals (Supit et al, 2019)
Kidney transplantation can save lives so that it is categorized as a legal activity, as long as the kidney used for transplantation is obtained ethically, does not contain elements of buying and selling, is not the result of murder or coercion to get people to donate kidneys
They understand that many kidney buyers are willing to buy, because 1.5% of deaths worldwide are due to kidney failure, and the majority of kidney transplants are successful in curing the disease (Peng et al, 2019)
Summary
Since 1977, Indonesia has used kidney transplantation as the last treatment option for patients with end-stage renal disease (ESRD), with a total of 629 transplants, which were carried out by 12 kidney transplant canter hospitals (Supit et al, 2019). WHO estimates that 5-10% of organ transplant procedures worldwide result from commercial transactions (Shimazono, 2007). Based on this phenomenon, the commercialization of human organs or tissues is prohibited by Indonesian law based on Article 64 (3) of Law Number 36 of 2009 concerning Health, and perpetrators are threatened with a maximum imprisonment of 10 (ten) years and a maximum fine of Rp. 1,000,000,000,00 (one billion rupiahs). Even though kidneys are prohibited, based on court rulings in 2016 and 2019 there are strong indications that there have been 81 cases of buying and selling kidneys for transplant purposes, because donors get money from recipients through brokers based on a written agreement. Kidney trafficking cases were discovered in Indonesia for the first time in 2016 (Putrawan et al, 2016)
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