Organ Trafficking Research Articles

Krüppel-Like-Factor 2, a new player in mucosal IgA homeostasis

Abstract Krüppel-Like-Factor 2 (KLF2) is a transcription factor that controls organ development, differentiation and trafficking of cells. In the immune system, KLF2 fosters the egress of T lymphocytes from the thymus via S1PR1 and promotes quiescent states of B lymphocytes as well as homing of antigen-specific IgG plasmablasts (PB) and plasma cells (PC) to the bone marrow (BM) via the α4β7 receptor. To investigate the PC-specific role of KLF2, we analyzed CD138+/TACI+ PB/PC subpopulations and isotype changes in various organs such as spleen (SP), BM, gut associated lymphoid tissues (GALT) and blood of KLF2-deficient mice in comparison to their mb1cre+ KLF2wt/wt controls. Therefore, FACS and Elispot analyses showed a striking reduction of IgA+ PB/PC in SP, BM and blood of non-immunized mice. Elisa and multiplex data revealed a strong reduction in serum IgA as well as (s)IgA in the feces of KLF2-deficient mice. However, frequencies of IgA+ PB/PC were not changed in GALT but total PB/PC accumulated in mesenteric lymph nodes (mLN) and Peyer’s Patches. In addition, IgA secretion of these cells was not effected. Based on these data, we conclude that the observed IgA-deficiency in KLF2-deficient mice can in part be explained by impaired egress of class switched PB/PC from their organ of generation to survival niches in the bone marrow and gut by controlling the expression of integrins. To address the consequences of a dysregulated PB/PC migration during infection, we are analyzing a GALT-dependent immunization with recombinant Flagellin which is known to trigger a systemic IgG as well as an mucosal IgA response. Furthermore, we are identifying KLF2 target genes that control PC egress and trafficking by RNAseq of IgA+ PB/PC from the mLN of KLF2-deficient mice.

Medical Image Forgery Detection using Cnn

With the improvement of the computer technology, image processing techniques have become important in a wide variety of medical applications. Numerous new features have been added to satisfy people. People consult doctors online, without even visiting them. As health is a critical issue, we should take care with full attention and security. This paper proposes a medical image forgery detection system for the identifying whether the image is altered or not. The forgery done on the medical images can lead to various issues that can shake the medical industry this also promotes wrong diagnosis, organ trafficking etc. Hence a group of different forgery detection algorithms is described and by using the Convolution neural networks we can detect and the forged images. This paper also gives a brief outline about the advantages and disadvantages of the existing systems in forgery detection.

Encouraging Organic Food Consumption through Visualization of Personal Shopping Data

Although food retailers have embraced organic certified food products as a way to reduce their environmental loading, organic sales only make up a small proportion of total sales worldwide. Most consumers have positive attitudes towards organic food, but attitudes are not reflected in behaviour. This article addresses consumers’ attitude–behaviour gap regarding their purchase of organic food and reports on how visualization of personal shopping data may encourage them to buy more organic food. Through the design of the visualization tool, the EcoPanel, and through an empirical study of its use, we provide evidence on the potential of the tool to promote sustainable food shopping practices. Of 65 users that tested the EcoPanel for five months, in-depth interviews were made with nine of these. The test users increased their purchase of organic food by 23%. The informants used the EcoPanel to reflect on their shopping behaviour and to increase their organic shopping. We conclude that the visualization of food purchases stimulates critical reflection and the formation of new food shopping practices. This implies that food retailers may increase sales of organic food through using a visualization tool available for their customers. In this way, these retailers may decrease their environmental impact.

A review of policies and programmes for human organ and tissue donations and transplantations, WHO African Region.

Several resolutions, endorsed by the World Health Assembly and the United Nations General Assembly, articulate the need to improve the availability, quality and safety of organ and tissue donation and transplantation, as well as to prevent and combat trafficking in human organs. Here we assessed the implementation of these resolutions pertaining to organ and tissue donations and transplantations by sending out a questionnaire to all 47 countries in the World Health Organization African Region. From 33 countries that provided data, we identified several obstacles and challenges. Compared to other regions, there are very limited data on organ donation and transplantation. Most countries are lacking legal and regulatory frameworks, since they did not yet establish a specific or comprehensive legislation covering donation and transplantation of human organs and tissues. Countries also have a poor national capacity to perform organ and tissue transplantations and the organization and management of national programmes are weak. Funding, both from domestic and external sources, is insufficient to implement effective transplantations programmes and patients have inadequate financial protection. To address these challenges, we propose that countries and partners should develop and implement policies, strategies, plans and regulatory frameworks for all aspects of organ and tissue donations and transplantations, including fighting against organ trafficking and transplant tourism. Where donation and transplantation programmes exist, stakeholders should develop the skills of human resources, adopt technical standards and quality management procedures to improve donation and transplantation of human organs and tissues.

Modifiable Cardiovascular Risk, Hematopoiesis, and Innate Immunity.

Unhealthy diet, lack of exercise, psychosocial stress, and insufficient sleep are increasingly prevalent modifiable risk factors for cardiovascular disease. Accumulating evidence indicates that these risk factors may fuel chronic inflammatory processes that are active in atherosclerosis and lead to myocardial infarction and stroke. In concert with hyperlipidemia, maladaptive immune system activities can contribute to disease progression and increase the probability of adverse events. In this review, we discuss recent insight into how the above modifiable risk factors influence innate immunity. Specifically, we focus on pathways that raise systemic myeloid cell numbers and modulate immune cell phenotypes, reviewing hematopoiesis, leukocyte trafficking, and innate immune cell accumulation in cardiovascular organs. Often, relevant mechanisms that begin with lifestyle choices and lead to cardiovascular events span multiple organ systems, including the central nervous, endocrine, metabolic, hematopoietic, immune and, finally, the cardiovascular system. We argue that deciphering such pathways provides not only support for preventive interventions but also opportunities to develop biomimetic immunomodulatory therapeutics that mitigate cardiovascular inflammation.

Crime Investigation of Trade of The Human Body Organs on Criminal Investigation Police (Case Study Police Report Number: LP / 43 / I / 2016 / Bareskrim dated 13 January 2016)

The purpose of this research know and analyze doubt enforcing the investigation of criminal trafficking of human organs carried out by the Criminal Investigation Police, to determine the factors that affect the implementation of the investigation of criminal trafficking of human organs carried out by the Criminal Investigation Police, to know the efforts the police in tackling the trade in human organs and factors inhibiting the Police in tackling trafficking in human organs.The method used is the method of normative and juridical sociologic, the specifications in the study was a descriptive analytical methods of population and sampling are all objects or all of the symptoms or the entire event or the entire unit to be studied, data collection techniques using literature study and interviews, data analysis is qualitative.Result: Implementation of the investigation of criminal trafficking of human organs in accordance with the Regulation no. 14 Of 2012 on Management Investigations. In the process, the investigator did not experience any problems in the arrest of the perpetrators, because in the process of investigation the investigator obtain complete information from the victim as well as by using techniques evident triangle obtained further evidence used to ensnare offenders. The factors that affect the implementation of the criminal investigation of organ trafficking the human body that carried out by the Police Criminal Investigation divided into two: a supporting factor comes from: the power of law enforcement officers who have sufficient personnel and high professionalism, Police efforts to combat trafficking in organs, namely prevention, eradication and prevention of the crime of trafficking of human organs by running strategy repressive functions, namely in the form of punishment with the most severe penalties. Factors inhibiting factor is the legal, law enforcement, means infrastructures, society and cultureKey words: Investigation; Crime; Trafficking; Human Organs.

Food for thought

PurposeThis paper seeks to identify the factors that influence the perceptions and attitudes of young people in Montenegro toward organic products.Design/methodology/approachThe results of the research, obtained using the multivariate factor analysis, showed that the vast majority of young consumers identify organic food as healthy and natural and that its higher price is a significant barrier inhibiting their likelihood of purchasing it, along with inaccessibility and the limited options offered.FindingsThe data obtained provides valuable information for managers and decision-makers working in organic food production and sales in Montenegro – a country with the potential to develop in this field.Research limitations/implicationsThe study was carried out in the CEE transition country of Montenegro, with 300 young consumers. Further research is needed to validate the results through longitudinal study.Practical implicationsThe data obtained represents a meaningful contribution to the field of organic food production and sale in Montenegro (which is a country with a lot of potential in this area) and will assist managers and decision-makers in the field.Social implicationUnlike most research that has previously examined issues concerning organic production – such as its standardization, financing, environmental impact, and even its promotion – this paper provides a better understanding of the behavior of young consumers toward organic products in Montenegro by outlining their perceptions and attitudes toward this product category.Originality/valueThis research represents the first academic study of customers' attitudes and perceptions in this area, alongside the main factors affecting the young consumer's choice to purchase organic food in Montenegro.

Organ Procurement and Extrajudicial Execution in China: A Review of the Evidence

The Victims of Communism Memorial Foundation (VOC) has conducted a detailed examination of the allegations of extrajudicial killing for the harvesting of organs by the Chinese Communist Party and the evidence underlying these allegations. The report was produced by VOC China Studies Research Fellow Matthew P. Robertson, a doctoral researcher whose work using statistical forensics to demonstrate the falsification of Chinese organ donor registry data was recently published in the leading journal of medical ethics, BMC Medical Ethics. The report contributes to the literature and policy discussion on coercive organ transplant practices in China in several ways: it presents new primary documentary research and original datasets, integrates established scholarship on China’s death penalty system, and situates previously published works on organ harvesting within a careful discussion of counterfactual scenarios and scientific inference. It also serves as a roadmap to the debate about and evidence of extrajudicial killing for organs in China, while also critically engaging with how that evidence has been interpreted and received. The report challenges international complacency on the topic by examining the signs of ongoing organ trafficking, highlighting the falsification of official datasets, and analyzing the evidence that Uyghur Muslims may be the latest victims of this form of state predation. In examining the extraordinary growth of organ transplantation and rapid availability of organs in China, the report asks one overarching question: What is the most plausible explanation for the source of the organs? The report examines the evidence of blood-testing and medical examinations of Falun Gong practitioners and Uyghurs in custody, and finds that extrajudicial organ sourcing from these populations is the most plausible and parsimonious explanation. As such, readers should adopt it as empirically adequate until either a better explanation or reliable data inconsistent with the hypothesis emerges.

Why Is Family-Oriented Organ Transplantation Policy and Practice Necessary for Bangladesh?

In the West, in countries such as the US and UK, people are equally encouraged to donate organs both to their relatives and nonrelatives. In practice, although family is the priority in the US and UK, anybody can donate organs to anyone else lawfully. Contrastingly, in Bangladesh, people are only legally allowed to donate organs for transplantation to close relatives. Bangladesh’s living organ transplantation policy and practice is in stark contrast with the Western secular biomedical perspective. In this artcile, I address that the notion of individual freedom and liberty in regard to the donation of organs for transplantation in the West is consistent with secular culture and biomedical perspectives, but such biomedical policy and practice is at odds with the Bangladeshi Muslim culture, socio-economic reality and biomedical perspective. As Bangladesh is a family-oriented collective society, the kinship relation and strong familial bonds may encourage relatives into donating organs to a patient. More than 20% of people still live below the poverty line, and the COVID-19 pandemic has pushed poor people into extreme poverty. The practice of allowing unrelated altruistic donors as is done in the West and Iran, or even in the special circumstance in Paksitan, the act of donating organs will comprehensievly increase organ trade in Bangladesh, which in turn will cause more harms than benefits. This study conludes that the government should uphold family-oriented biomedical policy and practice in Bangladesh until poverty is eliminated. It implies that patients who do not have close relatives, or whose poetntial relative donors are medically unsuitable for transplantations should wait for deceased organs for transplantation.
 

Authentication and Analysis of Purported Undercover Telephone Calls Made to Hospitals in China on the Topic of Organ Trafficking

The People’s Republic of China operates one of the largest organ transplantation systems in the world as measured by transplant volume, yet its operations are cloaked in official secrecy. A great deal of contention has surrounded the source of the organs, whether voluntary donors, death row prisoners, or prisoners of conscience. It is difficult to gather reliable data about the operations of China’s transplant program, and Chinese authorities have been found to disseminate falsified donor registry datasets. One source which may shed light on empirical questions about China’s transplant system is a cache of telephone calls made by investigators to transplant hospitals in China. The investigators pose in a range of plausible identities, and make enquiries about organ availability, health, and donor source. The matter of whether these telephone calls may be used as valid evidence in social scientific research is not immediately clear, given questions of source and selection bias, and even the basic facticity of the calls themselves. This working paper aims to establish whether or not the audio files are in fact what they purport to be — that is, actual calls to hospitals in China — and considers issues associated with their potential use by researchers.

SAT-334 DISPARITIES IN TRANSPLANTATION ACCESS ACROSS DIFFERENT COUNTRIES: AN ISN FELLOWS COLLABORATIVE STUDY

Kidney transplantation (KTx) is the best modality of treatment for kidney failure. Access to KTx should be available to all patients with end-stage kidney disease (ESKD). However, disparities in access to KTx exist and are more complicated in low and middle income countries. We sought to discover challenges facing these countries in providing universal access to kidney transplantation through this International society of Nephrologist (ISN) fellows collaborative review. The ISN fellows collaborative review conducted with the participation of ISN fellows from 11 countries. Countries profile including population size and density, gross national income per capita and total expenditure on health per capita, total expenditure on health and life expectancy at birth were referenced from World Health Organization (WHO) and UN online data source. Information regarding the national transplant programs, nephrology societies' database, national KTx registry data and literature search with other specific data collected from each ISN fellow and/or country representatives were described across the countries. Only three of the 11 countries have transplant registries and four of the rest are developing a registry. Except Turkey and Kazakhstan, there is no full governmental coverage for KTx. Both Cameroon and Democratic Republic of the Congo (DRC) have not initiated a kidney transplant program yet. In all countries except Cameroon and DRC, KTx from living donors is available. The most important barrier is the lack of deceased donors and lack of clear concept of brain death in most countries. High cost of KTx and the first year maintenance immunosuppressive treatment is the second important barrier for the countries considered. In almost half (5/11) of the countries, organ trafficking is still present, yet decreasing with governmental effort. Still absent are legal regulations and governmental precautions in some countries. *Barriers category: A,high rate of brain death unacceptance by relatives; B,Long waiting time; C,Insufficient Deceased donor; D,Paid unrelated live donors; E,No institutional support and legal laws; F,Lack of tissue typing; G,High cost of medicine; H,Insufficient Living& Deceaseddonor; J,Cultural/spiritual impediments; K,Low number of referrals Multiple challenges are facing LMICs countries to provide universal access for kidney transplantation to patients with ESKD. Governmental and educational awareness programs should be encouraged to increase the number of deceased donors. Transplant cost has to be reimbursed by governments to encourage KTx for patients with ESKD. The concept of brain death should be clarified, legislations for deceased donation should be adopted and strict regulations to stop organ trafficking are much needed.

Organ Transplantation in Ecuador.

Organ Transplantation in Ecuador.

SAT-297 KIDNEY TRANSPLANTATION RECIPIENTS’ EXPERIENCE IN ORGAN TRAFFICKING

Kidney transplantation is the gold standard for patients with end-stage kidney disease. In view of shortages of available organs, long wait times for possible transplantation, and strict regulation, many patients opt for commercial transplantation. This study elicits the reasons and motivations for patients with end-stage kidney disease to elect for commercial transplant. A questionnaire-based evaluation was conducted during the period from July 2015 until late December 2015. It consisted of 29 multiple choice questions and was distributed to all patients who underwent commercial kidney transplantation. One hundred and fifty patients were approached to participate and 106 agreed. Of the participants, 60% were male with an average age of 41.5 (SD 14.8) years and ranged from 18 to 83 years. The majority (82%) of our participants were educated ranging from primary to college level. The major reason (71%) for these participants to obtain commercial transplants was stated as the unavailability of a live related donor. Thirteen percent stated that they objected to getting a kidney donated from a family member, and 9% stated that they were worried about taking a kidney from a family member. Finally, 3% of participants stated that they needed prompt transplant and could not wait for a long time for transplant investigations and the workup associated with this program. The study showed that patients often travel outside their country border to seek medical treatment for ESKD through organ transplantation due to the lack of a strong health system that provides all necessary tools of care. Oman, similar countries in the regions, and various other countries around the world must empower their citizens, provide the care required to improve their lives, and preserve dignity and human values. Efforts must therefore be directed towards strengthening the national program with full logistic, financial, and strong legislation to protect human lives locally, regionally, and globally and must collaborate with international efforts to combat organ trafficking and commercialism and to encourage the notion of humanity’s best interest.

A very lucrative liquid: the emerging trade in human milk as a form of reproductive exploitation and violence against women

PurposeAn emerging market in human milk exists for both nutritional and biomedical research purposes. This commercialisation of human milk, however, raises issues about the exploitation and violence against women.Design/methodology/approachThis paper explores the framing of the issues as one of human rights, and whether the shifting of gender issues away from gender-specific spaces in legal and ethical debates, makes their ethical consideration and the tangible consequences from these considerations, into a potential further sources of exploitation and other forms of violence against women.FindingsThe authors find the commoditisation of human milk as a nutritional product deprives women from the centrality of their roles and, therefore, from the upholding of women rights and the adequate prevention of violence against women. They identify an emerging space where trafficking in women and girls can occur for their milk as part of a broader set of practices of reproductive exploitation. They also identify that existing legal, ethical and research discussions often frame labour or organ trafficking as the appropriate framework but find this inadequate to address the inherently gendered aspect of reproductive exploitation. The current response makes trafficking in women for their milk a potential practice while concealing the structural inequalities that underpin women’s experiences as the buyers and sellers of human milk.Practical implicationsThe regulation of human milk sale should therefore move from a public health paradigm focused on safety to one of health and women’s rights, whereas human trafficking laws around the world should explicitly address reproductive exploitation.Originality/valueEmerging forms of exploitation, such as human milk sale remain underdiscussed alongside other more prominent forms of reproductive exploitation, such as surrogacy. The authors call for explicit consideration of the emerging trade as its burdens fall exclusively on women and existing frameworks for addressing exploitation often overlook these emerging practices and the structural inequalities faced by women that drive these trades.

Jual Beli Organ Dalam Manusia Untuk Kebutuhan Tranplantasi Dalam Pandangan Hukum Islam

Transplantation is a medical procedure performed by moving healthy organs to replace damaged organs. Currently, transplantation has been very developed and used in various countries including Indonesia. Indonesia prohibits the sale and purchase of organs because the principle of freedom of contract in Indonesia is faced with ethics, religion and culture that influence it. Indonesia also has regulations related to transplantation, namely Law No. 36 of 2009 concerning Health and Government Regulation No. 18 of 1981 concerning Clinical Cadaveric Surgery and Anatomical Cadaveric Surgery and Transplantation of Human Body Organs or Tissues and several other Ministerial regulations, but some of these regulations are known to be incomplete and tend to be unclear because there is a blurring of norms in them. Until these regulations are no longer efficient to use anymore. So the government recently issued a regulation related to transplantation, namely PP No. 53 of 2021 concerning Organ and Tissue Transplantation. Learning from some of the previous problems and also the fact that transplantation is not only problematic in its regulation but also due to Islamic law factors. The questions raised in this research are first, how is the regulation of human organ transplantation in National law and Islamic law. Second, how is the legal expediency of human organ transplantation in the perspective of National law. This type of research is normative juridical with descriptive qualitative legal material analysis. With the results of the conclusion, first, Indonesia currently has regulations regarding transplants that are more complete and clear and have been correlated quite well even though not all provisions in Islamic law are adopted in it. Second, the current transplant regulation has also fulfilled the elements of expediency, the regulation does not conflict with the law above it.

Insuffisance rénale terminale au Maghreb et en Afrique : panorama des programmes de transplantation au Maghreb et en Afrique

Kidney transplantation is the best treatment for the patient with end stage kidney disease in term of increasing the survival rate, reducing complications, improving quality of live and its lower cost compared to peritoneal dialysis or hemodialysis. However, the number of patients waiting for kidney transplantation is growing day by day and the gap between demand and supply is still huge. This situation is even more complicated in developing countries where the lack of legislation, infrastructure and government involvement is common. Some national transplantation programs have been implemented, with the support of the International Society for Transplantation and the International Society of Nephrology, in order to increase the transplantation activity of these countries in accordance with the Istanbul Declaration on organ trafficking and transplant tourism.

Legalization of Giving Award to Organ Donors in Indonesia (In Perspective of Law No. 36 Year 2009 Jo Minister of Health Act No. 38 Year 2016)

Indonesia as a country included in the scope of the United Nations (UN) in making and drafting legislation can adopt international policies. Buying and selling human organs illegally is a threat of crime for humanity or Crimes against Humanity . The UN then formulated the practice of trafficking in human organs carried out by means and purposes illegally constituting transnational crime. Based on the formulation of the Thereto Protocol , it is explained that theft, coercion and exploitation in the practice of human trafficking, including human organs are prohibited and must be eradicated. The Thereto Protocol does not prohibit the giving of compensation to donors by the recipient and does not specifically regulate the sale and purchase of organs which specifically prevents coercion and exploitation of humans in all its forms, including exploitation or forcible removal or removal of organs, and this is what is said illegal and deserves punishment. Providing compensation/awards to donors in Indonesia should not be prohibited and can be legalized to obtain the right to welfare and health for the loss of organs donated without coercion. The right to obtain welfare is regulated in Article 28H paragraph (1) of the 1945 Constitution of the Republic of Indonesia NRI of the Republic of Indonesia (hereinafter abbreviated to the 1945 Constitution Republic of Indonesia) as follows. Every person has the right to live in physical and spiritual prosperity, to live, and to have a good and healthy environment and to have health services. The awarding of donors to donors as stipulated in Law No. 36 of 2009 in conjunction with Minister of Health Regulation No. 38 of 2016 requires protection, supervision and guarantees of legal certainty from the Indonesian government in the form of a central and or regional transplant commission so that donors are not criminalized as organ sellers as a prohibition on organ trading as stipulated in Article 64 of Regulation No. 36 of 2009.

Liver Transplant Tourism.

Liver transplant tourism is travel for transplantation involving organ trafficking and/or transplant commercialism. Various medical, financial, and organizational factors play a role in transplant care including waiting lists, Model for End-Stage Liver Disease scores, and financial aid. We outline the international experiences with transplant tourism (TT) and its effect on their medical communities and patients. For clinicians providing care to patients involved in TT, we also discuss pretransplant counseling and posttransplant care.

A Mosque-Based Qualitative Study on American Muslim Women's Organ Donation Beliefs.

Detailed studies on the associations between religious beliefs and organ donation attitudes among religious minorities remain wanting. Although Muslims appear to have low rates of support for donation, how these behaviors relate to religious frameworks requires further investigation. We sought to explore the relationship between religious beliefs (Islam) and organ donation attitudes through focus groups with 43 Muslim women from 5 Chicago-area mosques. Purposive selection of mosques generated near-equal representation of Arabs, South Asians, and African Americans, as well as diversity in education and income. Using the theory of planned behavior as our conceptual framework, we expanded the traditional normative domain to include religiously informed beliefs. We found that the relationship between religious beliefs and Muslim attitudes toward organ donation is more complex than commonly perceived. Regarding the Islamic ethicolegal permissibility of organ donation, participants expressed a range of normative beliefs. Furthermore, participants voiced concerns beyond religious permissibility, including anxieties over modesty violations during the donation process, as well as concerns about purported black market organ trade and medical risks to donors. Given that participants raised religious, societal, and biomedical concerns regarding organ donation, our findings suggest that effective educational programs should involve nuanced curricula that teach to the plurality of Islamic ethicolegal opinions and discuss transplantation processes within the United States.

Assessing the Potential Impact of the Declaration of Istanbul 2008 on Internet Reporting of Human Organ Transplantation-Related Crimes Using Interrupted Time Series Analysis and Meta-Analysis Approaches

BackgroundA severe shortage in donor organs is the major driver for organ transplantation-related crimes. The Declaration of Istanbul 2008 (DOI) was created to stop such crimes. We investigated the impact of DOI on Internet reporting of transplantation-related crimes. MethodsWe conducted Google Advanced Searches to collect data on “kidney trade,” “kidney sale,” “organ trafficking,” and “transplant tourism” in 15 original participant and 10 nonparticipant countries, 6 years prior through 8 years after the promulgation of DOI. The data were normalized for population and transformed to a logarithmic scale. Interrupted time series analysis (ITSA) was applied to estimate the changes in slopes of the outcome variables before and after DOI, and then the overall intervention impact was calculated by meta-analysis. ResultsThe combined results indicated that the overall impact of DOI on the reporting of “organ trafficking” and “transplant tourism” was statistically negative (reporting reduced significantly) as intended but on “kidney sale” and “kidney trade” was statistically positive (reporting increased significantly), and the increase was higher in the nonparticipant countries compared to the participant countries. The rate of reporting on “transplant tourism” declined in the participant countries more pronouncedly than in the nonparticipant countries. ConclusionsDOI has a positive impact on the reporting of “organ trafficking” and “transplant tourism” but not on the reporting of “kidney sale” and “kidney trade.” The increased reporting of “kidney sale” and “kidney trade” can be indicative of an impact of DOI on public awareness and increased reporting of the residual transplantation-related crimes.