London An investigation has exposed the organised criminals who secretly trade organs for British transplant patients for as little as £4,500 (Dh25,500).

The gangs, operating in eastern Europe and the Indian subcontinent, prey on the desperation of patients requiring organs and the poverty of donors who often earn less than £1,000 from the exploitative deals.

The so-called organ brokers have developed a network of corrupt officials who provide fake documentation to show that donors are related to the recipients, a legal requirement in Britain and several other countries. They have also recruited corrupt doctors who conduct medical tests and help arrange transplant operations in the donors’ homelands.

Police are investigating the first case of people-trafficking for organs in Britain after a woman was brought to the country last month by an eastern European gang that planned to sell her kidney.

However, the international trade in human organs has been flourishing for several years. Last month, a report by the World Health Organisation estimated that 10,000 black-market transplant operations take place each year.

The illicit trade begins with men such as Tsvetan. He and several other touts were found loitering outside a blood transfusion centre in Sofia, the capital of Bulgaria, as they offered poor and homeless people £16 for a unit of their blood. The blood is resold for as much as 10 times that sum.

Far more lucrative, however, is the buying and selling of organs — a point not lost on Tsvetan as he listened to an undercover reporter detail how a female relative in London required a kidney.

Tsvetan asked for the woman’s blood type and on being told she was A positive replied: “We have that available. I have a man who has exactly that blood type. We have his full medical reports. When you see that everything is right then we can talk about money and the guy will go with you to London.”

Hours later, he summoned the reporter to a cafe where he handed over a bundle including blood reports, ultrasound scans and X-rays.

Pointing to one, he said: “Look, he is A positive, everything is in order. He has no diseases — HIV, hepatitis, everything is negative. We were going to sell his kidney to another patient but the guy died before the transplant could take place. You are lucky. I am in charge of him and I can promise you that he will go to London and let you have his kidney.”

Two days later, Tsvetan, his boss Traicho and the donor, Minko Asenov, met the reporter at another cafe. Traicho said: “You can take him to the doctor to check that he is still healthy and his blood group is fine. We will make the appointment tomorrow with the doctor who is our friend, he works at the top hospital.

“He knows everything that we do. The doctor is in the kidney unit and knows that this guy will be selling his kidney. He can do all the tests.”

Asenov, a retired factory worker and father of three from Vratsa, a town in eastern Bulgaria, supplements his benefit payments by salvaging scraps from dustbins to sell. “I have sold my blood more than 20 times. We are poor people and this is a way to make good money,” he explained.

Traicho said Asenov would be escorted to Britain, adding: “We have sent someone to London before for a transplant. There were no problems.” He quoted a price of €20,000 for Asenov’s kidney.

Organ transplants in England and Wales are regulated by the Human Tissue Act 2004, which prohibits the selling of organs. To combat trafficking, doctors must follow strict rules requiring them to satisfy themselves that a donor is not being paid or coerced.

Aware of such strict rules, the gangs have a network of officials who provide bogus papers showing a donor is related to the recipient.

It took Traicho and Tsvetan less than an hour to bribe a council official to sign and stamp a document falsely showing Asenov was the father-in-law of the woman awaiting a kidney in London.

In Bulgaria, the 2004 organ transplant act makes it an offence to provide an organ to anyone who is not related to the donor by blood or marriage. Fines of up to £204,000 can be imposed.

Kiro, in his fifties, runs a rival organ trafficking gang in Sofia. He warned the reporter who had approached him seeking to buy a kidney: “We are serious people. We don’t mess around. The price is £20,000.”

The deal struck, factory worker Dimitar Doychenov was ushered to the table. “I’m doing this for my son who is 18 months old,” he said. “I’m 30 so I should recover fast.”

His confidence is misplaced. Donors, particularly those undergoing surgery in less developed countries, face poor medical care or are ripped off.

Recipients operated on abroad are also in peril. In 2002, a study at Birmingham’s Queen Elizabeth hospital found 29 NHS patients nationwide had bought kidneys overseas. In more than half the cases, the kidney had subsequently failed.

According to Kidney Research UK, almost 7,000 Britons are awaiting a transplant yet fewer than 1,700 kidneys become available each year — tempting some to look overseas.

Anthony Nicholls, consultant physician and nephrologist at the Royal Devon and Exeter hospital, said: “A patient of mine went to China to get a kidney which he paid for and got a wound infection. Medical and surgical care in foreign hospitals does not often match our high standards.”

The potential risks have failed to dissuade men such as Sanjay Srivastava, a 38-year-old office assistant recruited as a donor by a gang operated by Hemchand Kallu, a private ambulance fleet owner in Delhi.

At a meeting with an undercover reporter in the city’s Connaught Place, Kallu acknowledged the trade was illegal but said: “I have somebody who is ready to donate. He is in need of money and will sign any papers. Donors are not a problem. The kidney will cost you between Rs400,000 and 500,000 [£4,500-5,700].”

Later, Srivastava explained: “The money will help me to get my sister married.”

In case he was not a match, Kallu arranged for the reporter to meet another potential donor — a 30-year-old divorced mother of three called Seema Khan. She said: “I just want to give my children a better life.”

Doctors are also involved. In Delhi, SK Gupta, a GP recommended by Kallu, suggested the transplant be carried out in India where he estimated it would cost £15,000. He claimed to have previously helped other British transplant patients.

Explaining how paperwork falsely stating a relationship between donor and recipient would be required, he said: “Paperwork will cost you an additional Rs100,000. All that will be sorted. What happens in the office? Everybody gets a cut. That’s how it’s done.”

When confronted by phone, Gupta hung up. Those wishing to donate organs for transplant in India must prove they are related to the recipient or, if the donation is altruistic, prove no payment is being made. The rules are widely flouted.

Ashok Chand, deputy commissioner of police in Delhi, said: “We take crimes like this very seriously.”

Bulgaria’s interior ministry said it would investigate any allegations of organ trafficking.