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"The FDA recalled more than 60,000 tissue-derived products between 1994 and mid-2007."
July 20, 2012 7:26 AM   Subscribe

"The business of recycling dead humans into medical implants is a little-known yet lucrative trade. But its practices have roused concerns about how tissues are obtained and how well grieving families and transplant patients are informed about the realities and the risks." After an eight month international investigation, the International Consortium of Investigative Journalists has published an extensive four-part exposé into the black market for cadavers and human tissue: Skin and Bone: The Shadowy Trade in Human Body Parts (Via)

The ICIJ (Previously on Mefi) was established by the Center for Public Integrity (CPI) to serve as its international reporting arm. The CPI is a nonprofit investigative journalism organization.
Key Findings:

* Consent: There have been repeated allegations in Ukraine that human tissue was removed from the dead without proper consent. Some of that tissue may have reached other countries, via Germany, and may now be implanted in hospital patients.
* Safety: Surgeons are not always required to tell patients they are receiving products made of human tissue, making it less likely a patient would associate subsequent infection with that product.
* Tracking: The U.S. is the world's biggest trader of products from human tissue, but authorities there don’t seem to know how much tissue is imported, where it comes from, or where it subsequently goes.
Sections:
* About this Project
* Infographic: How Safe is Human Tissue?
* Part 1: Human Corpses are Prize in Global Drive for Profits
* Part 2: Body Brokers Leave Trail of Questions, Corruption
* Part 3: Traceability Elusive in Global Trade of Human Parts
* Part 4: Abusing the 'Gift' of Tissue Donation
* Key Questions About Human Tissue
* Japan has almost no regulations on human tissue. Includes a link to an Asahi Shimbun investigation with further details.
* Video: Skin and Bone
* How We Did It: Analyzing the Data behind Skin and Bone The investigation utilized software from Palantir to analyze networks and data on an impressively large scale: "We uploaded more than 1 million companies, individuals and events (such as imports, seizures and recalls) into Palantir to build out a network previously buried in data sets and documents. The result was a rich and dense dataset that made it easy to grab a comprehensive picture of any entity in just a few key strokes. It therefore becomes a powerful reporting tool, rather than merely a way to visualize networks."
* Methodology: Behind the Numbers
* Video: How ICIJ investigated human tissue trading networks
* Multimedia: Products made from human tissue
posted by zarq (32 comments total) 29 users marked this as a favorite

 
About two inches worth of my lower jaw was reconstructed from ground up dead people. I am not entirely sure I want to read any of these links.
posted by elizardbits at 7:39 AM on July 20, 2012 [2 favorites]


Famed BBC journalist Alistair Cooke is in someone also.
posted by Damienmce at 7:46 AM on July 20, 2012


If I need a new organ, I want nothing other than top of the line Chinese Falun Gong political prisoner offal. Those folks don't do hard drugs or drink ethanol and have little in the way of sexually trasmitted diseases.

On a more serious note, the sooner we legalize real stem cell research and can grow new tissues, the sooner we can stop harvesting dead people and doing ethically dubious business practices.
posted by Renoroc at 7:50 AM on July 20, 2012 [1 favorite]


This is my shocked transplanted face.
posted by localroger at 7:50 AM on July 20, 2012 [4 favorites]


Since originally hearing that story, I've been trying to figure out how to make sure no one makes a profit off my donated body. I don't care what it's used for, but making a profit off of donated anything seems pretty skeevy. (Guess it's a successful business model though.)
posted by JoanArkham at 8:08 AM on July 20, 2012


Larry Niven was right!
posted by synthetik at 8:21 AM on July 20, 2012 [2 favorites]


Can we have your liver?
posted by Cash4Lead at 8:32 AM on July 20, 2012 [2 favorites]


Remind me not to die in Ukraine.
posted by Cash4Lead at 8:34 AM on July 20, 2012


Once I am dead I don't care who does what with me. Seriously. Have at it, people.

Please wait until I am dead though.
posted by cjorgensen at 9:03 AM on July 20, 2012 [5 favorites]


At the end of the ST:TNG episode "Heart of Glory", in which rogue klingons that miss the war invade the enterprise are killed, the supreme klingon commander phones in to apologize, and capt. Picard asks what to do about the body. Quoth the klingon: "whatever. it is only an empty shell now."

Of course, first you have to scream into the corpse's eyes at the top of your lungs -- but it's no mourning, it's a warning to the underworld to brace themselves, for a klingon warrior is coming.
posted by syntaxfree at 9:08 AM on July 20, 2012 [2 favorites]


Seriously now,

Once I am dead I don't care who does what with me.

Dude, the problem with this is that "death" is not well-defined. So much wiggle space here.
posted by syntaxfree at 9:13 AM on July 20, 2012


NPR has been doing a special series based on this report. Four articles have been aired so far, not sure if more are planned.
posted by hippybear at 9:16 AM on July 20, 2012 [1 favorite]


Once I am dead I don't care who does what with me. Seriously. Have at it, people.

How about if you knew you had Hep C? Would you be fine knowing that some shady company would cover that info up so they could get money for your skin or organs? Would you be okay knowing that some poor schmoe gets Hep C from a transplant from you?

I know you wouldn't. The problem isn't "oh I'm already dead so why should I care." You're alive right now, and can take (some) steps (depending on where you live) to try to ensure this kind of thing doesn't happen.
posted by rtha at 9:25 AM on July 20, 2012 [2 favorites]


rtha: that's an interesting possibility, but is it actually of concern? Most human tissue which is used for products has been sterilized before use, and that which cannot be is screened for disease. Are there any statistics about people contracting hepatitis from tissue-based products? I looked quickly through the links in this FPP, but that doesn't seem to be something mentioned in any way which leapt out at me.

Of much more concern to me is that there is an entire rather large money-making economy based on donated tissues which has until now remained fairly opaque to the public who are checking the organ donor box on their drivers license forms, unaware that being a donor means that, without specifically opting out (which isn't an option universally available in every state), you also are a tissue donor.

The idea that Big Money can be made off of corpses doesn't surprise me. What does surprise me is that this is being handled in a way which has been largely hidden from view, and which allows companies to basically harvest the dead without any remuneration to (or even often any real knowledge of) the family of the deceased.

I guess there could be real odd legal questions involved with selling corpses to medical product companies... and I don't have any problem with organ donation as it is truly a life-saving program. But having non-organ parts of the body harvested like a junked car at a pick-and-pull and then turned into lip-plumping matter for Real Housewives cast members... that just feels wrong to me somehow.
posted by hippybear at 9:39 AM on July 20, 2012 [2 favorites]


While alive I care about those things, rtha. Once I am dead not so much.
posted by cjorgensen at 9:42 AM on July 20, 2012


I've got bone graft material in my collar bone and my jaw now. I wish I didn't, naturally, but the alternatives are hard to think about. Still, my gratitude to those who provided it.
posted by tommasz at 9:47 AM on July 20, 2012


rtha: that's an interesting possibility, but is it actually of concern?

Yes. It's in one of the stories linked - I heard part of one of the NPR reports when I was on the way home yesterday or the day before.

Ah, here:
But soon after the transplants, the U.S. Centers for Disease Control and Prevention (CDC) learned the organ recipients had contracted hepatitis C. It turned out the Kentucky donor had a history of substance abuse and had served prison time. The tissue bank that recycled his remains, the CDC said, had screwed up the usual testing done to verify that tissues and organs were safe.

[...]

In some cases, inconsistent or non-existent recordkeeping prevents medical sleuths from ever finding potentially infected tissues. In one major case that played out in 2006, the U.S. Food and Drug Administration and five tissue companies moved to recall 25,000 tissues taken illegally from U.S. donors without proper consent or testing. Eight hundred of the tissues shipped overseas were never found.

The trade in human tissues is virtually untraceable at a global level. Poor accountability and inadequate safeguards have prompted concerns among medical experts that products made from bone, skin, tendon and other tissues taken from the dead could spread disease to the living — putting patients who receive tissue implants in dental surgery, breast reconstruction and other procedures at risk.
posted by rtha at 10:00 AM on July 20, 2012 [1 favorite]


Ah, okay. Fair enough.

Yeah, I thought it was interesting, in one of the NPR articles I heard yesterday, someone was saying that if you have a black box marketplace without sufficient regulation and oversight, you end up with a lot of problems. I immediately thought about all the fights against regulation of derivative markets and the financial industry. (Not meaning to derail, just was something that came to mind when I heard that.)

Part of that article I heard also went through how people who sign up for organ donations can, in many (but not all) states then go to a website to say how you want your tissues to be used after your death.

You can go to this NPR page and scroll down to find links of sample forms for states which allow such things, and a lot of those forms include URLs where you can go to either order a form or to fill out an online form.

When listening to the article I thought, well, heck, I don't care. But then I heard a second article about exactly how much money is being made, and thought that maybe I do care. I'll mull on that and possibly fill out a form sometime this weekend.
posted by hippybear at 10:07 AM on July 20, 2012 [3 favorites]


I decided I wanted to donate my dead body to science after being inspired by my great-aunt, who devoted the better part of her career to teaching high school science and decided to give her body to the medical university in my hometown. Then, when I was about 17, I read Stiff by Mary Roach and learned that the tissue from some bodies donated to hospitals is used in penile enlargement surgeries. For some reason, that really bothered me back then, but now I'm back on board with the whole idea. I've always been curious about what it's like to have a dick, so the idea of being one after I die is kind of cool is a bizarre kind of way.
posted by Mrs.Spiffy at 10:08 AM on July 20, 2012 [2 favorites]


Ah, cannot the poor find rest, must they be used even in death? The trade in skin and bones is not complete without seeing the prior history of resurrectionists. While in Edinburgh I was not too surprised that the city did not advertise its previous glory of being the Resurrectionist Capital of the World.
posted by jadepearl at 10:36 AM on July 20, 2012 [2 favorites]


My husband was a donor. I told them to take whatever they could use, and that included tissue. I can't think too much about what has become of it, and I could barely read these links.

elizardbits and tommasz, it is heartening to hear that those sorts of donations really improve people's lives and wellbeing.
posted by Fichereader at 10:39 AM on July 20, 2012 [2 favorites]


Using diseased tissues and organs... is it actually of concern?

Not to anyone who has money, of course. So the bastard who has made his fortune from a company trafficking in diseased cadavers will be able to purchase clean implants--and probably be able to purchase them while the 'donor' is still alive. The rest of us...eh.
posted by BlueHorse at 10:56 AM on July 20, 2012


I haven't looked at any of the links yet but just wanted to say this is an AMAZING post. I'm going to start on it this afternoon and spend the weekend going through it. Thanks zarq!
posted by triggerfinger at 11:19 AM on July 20, 2012


In a 24 hr newscycle world, this is a freaking HUGE amount of work. I too will spend a good bit of my weekend looking through the links in far more detail but AWESOME post and seriously detailed work.
posted by Wilder at 12:44 PM on July 20, 2012 [1 favorite]


Ah, cannot the poor find rest, must they be used even in death?

This is an interesting way to characterize this work, which is about organ and tissue donations, something which may have something to do with income and class, but pretty much this isn't about The Poor as a category of people affected.
posted by hippybear at 1:22 PM on July 20, 2012 [2 favorites]


Thank you zark!
posted by Katjusa Roquette at 3:00 PM on July 20, 2012


[CC] OrganDonor NonCommercial ShareAlike 1.0

- After death, pieces of this body may be included in other currently living bodies only if those other bodies will be available under the same license after death.

- You may not use this body for commercial purposes.
posted by pfh at 4:28 PM on July 20, 2012 [5 favorites]


rtha: that's an interesting possibility, but is it actually of concern? Most human tissue which is used for products has been sterilized before use, and that which cannot be is screened for disease. Are there any statistics about people contracting hepatitis from tissue-based products? I looked quickly through the links in this FPP, but that doesn't seem to be something mentioned in any way which leapt out at me.

actually, it is still not possible to sterilize tendons and other soft tissues that are transplanted. bone is also difficult to sterilize without destroying the properties that make it a successful transplant material; some bone materials for some purposes are not sterilized before use, even though bone can be sterilized. (soft tissues CAN be sterilized, but then they are usually useless because they are 'cooked'.) soft tissues can be disinfected (bioburden reduced by 3 log or 1000), but not sterilized (bioburden reduced by 6 log or 1000000). you'll note that even sterilization is not a guarantee that everything has been killed, just that virtually everything has been (and really, that is good enough usually).

you can find reports of infections spread by donated tissue and bones at the cdc website. i googled 'cdc infection allograft' and found this link:
http://www.cdc.gov/oralhealth/infectioncontrol/faq/allografts.htm
disease spread is extremely rare, but it does happen. any practitioner who says there is no risk from transplant is lying. the companies that process allograft tissue are not quite under the same regulations as drug companies or suppliers of other medical 'devices'. anyway, i have worked in the industry but i am not an expert. just wanted to raise some points...
posted by Tandem Affinity at 4:31 PM on July 20, 2012 [2 favorites]


Please wait until I am dead though.

Previously.
posted by hattifattener at 4:39 PM on July 20, 2012


Seems to me, the fact that this business is profitable is a good thing. It means it's viable. My dead corpse can make profit by being harvested for usable parts. Whether to make someone a new/bigger dick or to make them able to walk or see, it's happens in large part because someone makes a profit.

Profit can be a problem. It doesn't have to be. Profit motive is useful. Acting like it is automatically bad is a loosing attitude. So you donate your body. Good! Did that cover the cost of harvesting and preserving? How much processing is needed before it's in a form useful to whoever is working on the recipient?

Profit also can serve to pay for reasonable book keeping. But that will be lots easier if we can all just deal with the whole concept.
posted by Goofyy at 9:55 AM on July 21, 2012


My brother is at risk for Creutzfeldt-Jakob Disease because he had injection of growth hormone from human cadavers as a little kid. Unlikely he'll get it, but living with a sword over your head isn't so much fun. Ask Damocles. So, the health of the donor is quite important; record-keeping is quite important.

If tissue, corneas, bone, limbs, etc., are being sold for profit, the donor's family should be compensated. I'd like to think some med student will learn from my cadaver, but it's quite likely that a doctor will practice a new surgical technique on my arm, and another doctor will practice on my leg, etc., at a conference, where the organizer of the conference will make a bunch of money. Except that paying for body parts tends to allow for all sorts of bad things to get weird... er. So maybe tissue donation should support research.

That someone got my Dad's corneas always made me feel better. The non-profit organ donation system seems pretty successful.

I read that organ donation is rare in many countries. It's a nice trait that so many Americans are willing to be organ donors. (feel free to list other places where this is true. I'm not an intentional American jingoist, just too lazy to look it up.)

The profit system may have made some areas of medicine better, but I can't say it's helped patient care, as a whole, and US health care is obscenely expensive, absurdly profitable, and that hasn't made it insanely great.

If I could have a tummy tuck, and donate the excess skin & fat, yeah, I'd do that. That's how much I love science; freakin' philanthropist, that's me.
posted by theora55 at 1:47 PM on July 21, 2012 [1 favorite]




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