There’s long been an argument to establish a human-kidney market in the U.S. and other nations to reduce the ever-growing transplant waiting list. In telling the story of a kidney sale in Iran which does not end well for either side of the transaction, Francesco Alesi and Luca Muzi of the Guardian analyze that country’s legally sanctioned system, which plays upon the desperations of both buyers and sellers. An excerpt:

Iran is the only country in the world where it is legal to sell a kidney. The “Rewarded Gifting” act was approved by the Iranian Board of Ministers in 1997; two years later the waiting list for kidney transplants had almost disappeared. The state guarantees a cash reward of the equivalent of about £300 to each donor, and one year of medical insurance. But most of the “gifting” is done in private transactions.

Written in marker pen on the walls outside hospitals where transplant operations are performed are thousands of adverts like these: “A+ 25 years, I sell my kidney”, or “B neg sells kidney, 33, a bargain”. The essential information is blood type, phone number and age. The closer you get to 35, the maximum age to donate a kidney in Iran, the lower the price.

“I wanted to become a teacher, but I had to stop studying because of the disease,” says Ghaffar. “In these years I had only one purpose – to find a donor.” Ghaffar has called hundreds of numbers and has found 72 possible donors with his own blood type. They were all rejected by the doctors due to incompatibilities, or because of their poor health. “One year ago I found a donor, Ashkan, he passed all compatibility tests, but he took the money three days before the operation and disappeared. I was desperate.

“A few months later, I saw Narin’s notice. I called her, she wanted 20 million Toman, I could offer her only 13. In the end we agreed to 15 million [£3,600]”.

Ghaffar’s experience is unusual in Iran. Only the wealthy can normally afford to buy a kidney…•