Kidney sales by migrants: experiences, knowledge, and responses of medical professionals across the euro-mediterranean border.

Reports indicate that migrants are selling their kidneys, yet medical professionals' experiences with this are unexplored. We conducted a qualitative study with 45 professionals across the Euro-Mediterranean border (The Netherlands, Bulgaria, Türkiye, Italy, and Greece) working in transplantation and migration. We examined their experiences, knowledge, and responses to migrants' kidney sales and explored whether the issue is rarely encountered, insufficiently recognized, or disclosed. The study includes 28 transplant professionals (TPs) and 17 medical professionals working in migration (MMPs). Except for two TPs volunteering in migration settings, none reported direct encounters with migrant kidney selling. In contrast, five MMPs observed nephrectomy scars or heard testimonies. Awareness was largely limited to those with direct experience, and knowledge on modus operandi was absent. Both groups expressed uncertainty about detecting and reporting suspected cases. TPs tended to distance themselves and, like MMPs, acknowledged that limited awareness may reduce attentiveness. We conclude that migrant kidney selling remains largely hidden in medical practice, not because it is absent, but because it is insufficiently recognized and rarely disclosed. To address this, we recommend stronger collaboration through conferences, multidisciplinary training, and education on organ trade, as well as expanding reporting mechanisms to include migrant kidney sellers.