Meanwhile, China has made great strides in transplant techniques, having performed 35,000 kidney transplants since its first successful one in 1961. As a result, transplant centers have opened around the country, some with special wards catering to high-paying foreign patients.
Most of the organs are transplanted into Chinese citizens, but a growing number are going into foreigners, particularly Southeast Asians, Japanese and Americans, who would otherwise face years of illness or the risk of death if they were to wait for transplants in their home countries.
Hospitals welcome foreign patients because they pay as much as 10 times the price local patients pay for the same operation. For an American patient, the Chinese charges are somewhat below the comparative cost in the US.
It is hard to say how many Americans are receiving such organs each year. Anecdotal evidence in both countries suggests the number is small but growing and cuts across various regions.
"I think this is pretty widespread," said Dr. Diflo. "You'll see it anywhere you have an Asian community."
All five hospitals that do kidney transplants in Shanghai say they treat foreign patients.
"There was one from America in July or August," a nurse in the urology department at Changhai Hospital, affiliated with the Shanghai Second Military Medical University, recalled last week. The doctor who performed the transplant said the patient, a woman, recently returned home to California.
More than 78,350 Americans are awaiting organ transplants, according to the United Network for Organ Sharing, a nonprofit group that matches donors to transplant patients in the US.
With the wait for a kidney transplant stretching to six years or more in parts of the US, it is little wonder that patients with the necessary money and contacts opt for an ethically questionable transplant.
China is not alone in using prisoner organs to meet the demand for transplants. Taiwan also harvests organs from executed prisoners, albeit with strict consent requirements, as do some South American countries. The idea has even gained currency with some people in the US. Last year, a state lawmaker in Florida introduced a bill that would facilitate the transplant of organs from death row inmates after execution.
Transplant organizations in the US unanimously condemn such proposals, and the Florida bill, which did spark some debate, is unlikely ever to become law.
"Obviously a person condemned to death cannot consider organ or bone marrow donation as a coercion-free option," reads a statement by the ethics committee of the United Network for Organ Sharing.
Doctors are divided about whether to treat patients with transplanted organs from executed prisoners
Dr. Stephen Tomlanovich, a kidney transplant specialist at the University of California, San Francisco, has several patients who traveled to China to receive kidneys that he suspects came from executed prisoners. The patients involved told him that they were not certain of their organs' origins and Tomlanovich accepted that.
But if presented with a clear case in which an organ came from an executed prisoner, he says he would probably decline to treat the patient.
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