Black markets in organs for transplant surgery are not a monopoly of developing countries like Pakistan and the Philippines, it seems. The recent arrest of a New York dealer in illegal organs has exposed a world of shady deals in the US.

Levy-Izhak Rosenbaum was caught in an FBI sting late last month, along with a number of other people accused of various forms of corruption. He allegedly planned to buy a kidney from an Israeli and sell it to an American patient for $160,000. Prosecutors said Rosenbaum had boasted that he had brokered "quite a lot" of transplants over 10 years. This could be the first documented case of trafficking in the US.

However, American doctors have long suspected the existence of a black market. Buying or selling organs is illegal in the US and nearly everywhere else, except for Iran. But there is a thriving international black market.

In the wake of Mr Rosenbaum’s arrest, doctors admitted that they cannot screen out all commercial donors. "When you have the suspicion the donor is doing this for the wrong reasons, the question is — what do we do?" Dr Michael Shapiro, a transplant surgeon at Hackensack University Medical Center told the New York Times. "I don’t have a detective on retainer. I don’t have a polygraph. We’re pretty good at surgery, but part of the medical school curriculum is not interrogation techniques."

And some doctors and hospitals may not be asking too many questions about the motivations of third cousins or neighbours or friends from overseas who want to donate a kidney. "Some have a pretty cursory examination, like, `Are you sure you want to do this?'" bioethicist Arthur Caplan, told AP. "Some don't look very hard."

The number of unrelated kidney donors in the US has climbed rapidly in recent years. Between 1997 and 2006, it climbed from 7% to 24%. Much of this is due to medical advances which allow donations to patients even when the organs are not closely matched. However, some could be black market kidneys, Donna Luebke, a former board member at the United Network for Organ Sharing, the nonprofit group that runs the nation's organ transplant system, told AP. ~ New York Times, July 29; AP/Boston Globe, July 29