HONG KONG, China (Reuters) -- Paul Lee got his liver from an executed Chinese prisoner; Karam in Egypt bought a kidney for his sister for $5,300; in Istanbul Hakan is holding out for $30,700 for one of his kidneys.

Doctors in Pakistan have been arrested for abducting people, drugging them and stealing their kidneys.

They are not so unusual: a dire shortage of donated organs in rich countries is sending foreigners with end-stage illnesses to poorer places like China, Pakistan, Turkey, Egypt, Colombia and the Philippines to buy a new lease of life.

Lee, a 53-year-old chief subway technician in Hong Kong, was diagnosed with liver cancer in January 2005 but doctors denied him a transplant because they feared the tumor would spread.

A friend told him about a transplant hospital in China's north eastern Tianjin city and he signed up for a place. That April, he paid 260,000 yuan ($34,380) for a transplant -- surgery that saved his life.

"The hospital has connections with a lot of prisons," Lee told Reuters. "Mine came from an executed prisoner from Heilongjiang. I thank the donor deeply."

The World Health Organization estimates that 21,000 liver transplants are carried out annually, but medical experts put annual worldwide demand at at least 90,000.

Demand for kidneys also exceeds supply, and that has given rise to organ trafficking and a black market for rich people and "transplant tourists" who travel to poor countries to buy body parts from people with few other routes to a better living.

A donor in South Africa receives $700 for a kidney compared with $30,000 in the United States. A lack of transparency and little protection for donors has spurred calls by international bodies to crack down on, or at least regulate, the trade.

But even where the trade is banned, laws are often muddled or laced with loopholes, which are sometimes defended by vested interests.

And the unregulated route is much less complicated for the recipient. Any transplant procedure involving a living donor carries risks for the donor -- especially for liver transplants which involve removing part of the donor's liver.

The complications can include bleeding, infection, even death.

In the transplant trade, the recipient need not worry about, for example, exposing a living relative to that risk.

"It is cheaper and your next of kin is not taking the risk and you don't have to care for someone you don't know. Once you pay, it is discarded in a way, it is dispensable," said Luc Noel, a Geneva-based coordinator for Clinical Procedures at the World Health Organization.

China recently banned the sale of human organs and restricted transplants for foreigners, saying it must first meet demand at home for 2 million organs a year.

Only 20,000 transplants are carried out in China each year. Of these, 3,000 are liver transplants and 95 percent of them use livers from dead donors.

China defended its use of organs from executed prisoners, saying consent was obtained from convicts or their families. A transplant operation using the liver of a dead donor costs around $33,000 in China.

"What is important is the transparency, it has to be open to scrutiny ... if China makes its current system open to scrutiny and very transparent, that would do good," said the WHO's Noel.

In Asia, a cultural obsession with keeping the body of the deceased intact has stymied public organ donation programs.

Excluding China, Asia has fewer than 200 livers donated by people ahead of their death each year, said Lo Chung-man, professor of hepatobiliary and pancreatic surgery at the University of Hong Kong.

Pakistan, where trade in human organs is not illegal, is turning into a "kidney bazaar", said the chief executive of Pakistan's Kidney Foundation, Jaffar Naqvi.

There are no confirmed figures for the number of foreigners coming to the country for new kidneys but Naqvi said there were 13 centers in Lahore alone which reported more than 2,000 transplants last year from bought kidneys.

Patients, mostly from Europe, Saudi
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