Costa Rican authorities announced on Wednesday that they had broken up an international organ trafficking ring that worked with Israeli doctors and specialized in selling kidneys to patients in Israel and East Europe.

Costa Rica’s Attorney General’s Office said Israeli doctors had performed kidney-removal operations on some Costa Rican “donors” who sold their organs. Authorities also said the key suspect arrested in Costa Rica, a physician, had been in touch with Israeli doctors to match up Costa Rican kidney donors with Israeli recipients.

Performing such operations is a grave felony.

Costa Rican police together with Interpol are now investigating the case of a young woman who had been sent to Israel to donate a kidney, felt bad on the flight back, was taken off it at an interim stop and died.

Costa Rican authorities did not name any of the Israeli doctors alleged to be involved in the ring. Israel’s Health Ministry said it knew nothing about the affair.

In recent years Costa Rica has served as a destination for Israeli patients needing kidney transplants. The price for a kidney transplant on the black market is estimated at some NIS 700,000 per kidney.

San Jose police on Wednesday arrested Dr. Francisco Mora Palma, head of nephrology at the large Calderon Guardia Hospital, and raided a number of medical laboratories and clinics suspected of carrying out tests for the network’s doctors.

Attorney General Jorge Chavarria said the two people arrested − Mora Palma and an employee at Costa Rica’s Public Security Ministry − were the “tip of the iceberg” of the organ trafficking network.

Mora Palma was in touch with Israeli doctors and tested the suitability of the local residents whose organs were to be harvested in Israel, the Attorney General’s Office said.

Chavarria said the network’s doctors sent some of the “donors” to Israel to undergo the operation to have a kidney removed, while others had it removed in Costa Rica.

Sources involved in the investigation said they know of cases in which Israeli patients had been flown to Costa Rica to undergo surgery, without reporting to the health authorities.

Israel’s Health Ministry said in response to the report from Costa Rica that “the cases mentioned are not familiar and the Health Ministry does not know of them.”

It added: “Since 2008, when the New Organ Transplant Law was enacted, the health maintenance organizations and insurance companies stopped funding organ transplants ‏(which could be suspected of organ trafficking‏) for Israelis abroad. If Israelis did have transplants, as reported by the Costa Rica media, then they were funded privately, illegally and without the ministry’s agreement.”

About a year ago an Israeli organ-trafficking network was exposed in Israel. Its members used to fly Israeli patients for transplants in Kosovo and Sri Lanka. Other states suspected of having organ trafficking networks are Ecuador and Kazakhstan.

Chavarria also said Mora Palma and his associates used the hospital’s data bank to find suitable kidney harvesting candidates. These were usually needy men and women, who received $16,000-$20,000 for a kidney.

“We see these people as victims of an international crime ring,” the prosecutor said.

Israeli permits needed

If organ transplants arranged by the Costa Rican network were performed in Israel, as alleged, then the “donors” from Costa Rica appear to have obtained a permit for the harvest in Israeli hospitals, along with the approval of the Health Ministry committee that authorizes

organ donations from the living.

The committee authorizes donations from living donors who are not related, and is in charge of ascertaining that the donor was acting for humanitarian motives and did not receive payment for his organ.

However, in September 2005 the committee allowed an organ donation that had been presented as humanitarian, but after the death of the donor, a 38-year-old man from Ganei Tikva, it transpired that he had sold his kidney.

Until the New Organ Transplant Law was enacted, the HMOs sued to provide funding for Israelis’ organ transplants abroad, both as part of the complementary insurance and as part of state health insurance. This included states in which patients were required to pay the organ donors, like China and the Philippines.

However, since the law was passed, the number of Israeli transplants funded by HMOs abroad has been significantly reduced. Today they are performed only in states who allow organ donations from cadavers, and only if the hospital performing the operation signs a form ascertaining it does not deal with organ trafficking.

Thus, HMOs have approved funding for kidney transplants abroad only from cadavers in the United States, Russia and Latvia.

In 2007, 143 Israelis received kidney transplants abroad, but according to Health Ministry statistics, that number dropped to 35 in 2011. While transplants abroad have decreased, the new Organ Transplant Law has also led to a 50 percent increase in kidney transplants from live donors in Israel. Until two years ago Colombia performed 35 to 40 liver and heart transplants a year on Israeli patients in Medellin. But in the past year only four Israelis had transplants there, due to the restrictions imposed by Israel’s National Transplant and Organ Donation Center.

A senior official in the Clalit HMO recently asked Health Ministry director General Ronni Gamzu to arrive at a memorandum of understanding between Israel and Colombia to promote organ transplants there. The request was made ahead of Colombian President Juan Manuel Santos’ visit to Israel last week.

At the same time a group of patients awaiting transplants in Colombia have asked Health Minister Yael German to advance this initiative.

The Health Ministry has not decided on the issue yet.