When Kenichiro Hokamura's kidneys failed, he waited more than four years for a transplant before going online to look into rumours of organs for sale. As a native of Japan, where less than 10 kidney transplants are performed a year, the 62-year-old businessman was desperate. 'There are 100 people waiting in this prefecture alone and there were just three operations performed here last year. I would have died before getting a donor.' Still, he was astonished at how easy it was. Ten days after contacting a Japanese broker in China last month, he was lying on an operating table in a Shanghai hospital receiving a new kidney. A doctor had only examined him that morning. 'It was so fast I was scared,' he said. The 'donor' was an executed man, the price 6.8 million yen ($465,300). 'It was cheap [in comparison to the cost of my life],' said a recovering Mr Hokamura, now back in Kyushu in southern Japan where he runs a construction-related business. 'I can always earn more money.' Mr Hokamura is one of hundreds of well-off Japanese who have gone to China for kidney, liver and other transplants, drawn by the availability of cheap, healthy organs and improving medical facilities along the east coast of the mainland. The trade is also attracting a growing number of Koreans and other foreign nationals. There is no attempt to conceal the origins of the organs, the bulk of which come from prison morgues. 'My translator told me my donor was a young executed prisoner,' said Mr Hokamura. 'The donor was able to provide a contribution to society, so what's wrong with that?' After paying a local broker, many Japanese clients arrive in Beijing or Shanghai to find gleaming, well-equipped hospitals with world-class staff. Reports of problems with follow-up care and patients dying within one to two years of returning home have failed to stem the tide. 'I was surprised at how well everything was run,' Mr Hokamura said. 'I was expecting a lot worse.' Signs spray-painted on the walls outside clinics and hospitals in many parts of China are simple and direct: a mobile telephone number and the Chinese character for shen (kidney) written beside them. Ads on numerous bulletin boards and other internet sites also offer kidneys for sale. Although the sale of organs for transplants is illegal in China, a black market is flourishing. And it's not just the small private hospitals and clinics springing up over the country - bigger hospitals in the cities of Beijing and Shanghai have ads in toilet cubicles and on ward walls. 'We have to wipe off the notices on a regular basis. They even visit doctors, make numerous calls or write letters again and again,' Ding Qiang, head of urology at Huashan Hospital in Shanghai's Fudan University, told the media. 'Such donations are surely organ trading, but 'organ donation' for money is strictly banned in China.' In a bid to quell the black market in organ donations, the mainland's health ministry issued temporary regulations on human organ transplants on Monday which explicitly ban the sale of organs and set down medical standards for organ transplants. From July 1, any kind of dealing in human organs will be banned, unregistered hospitals will not be able to carry out organ transplants, hospitals will have to obtain written permission from donors before any transplants can be carried out and donors will be entitled to change their minds at any time. The central government reinforces bans on organ sales, but China is a huge country. The bans may have an impact on the illegal organ trade in the big public hospitals but regulation of private clinics and small hospitals is more difficult. A single broker has helped more than 100 Japanese make the trip to China for transplants since 2004 and the trade is growing. Official figures underestimate the number of people using the service, many of whom fly beneath the government radar. Mr Hokamura said his family was pleased that his daughter put his experience on the internet. In her blog, she said she felt sorry for those who had to wait years for transplants, and listed a link to a support centre in Shenyang. 'Other people should know about this.' But not everybody is as enthusiastic. 'I can understand the self-interested motives but I personally wouldn't do it,' said Louis Carlet, a resident of Tokyo who has been on kidney dialysis since November. 'I highly doubt that executed prisoners give their consent. If it was totally consensual I might think about it, but the fact that there's profit involved turns me off.' Many patients in Japan, however, are bitter about the underdeveloped state of transplant health in a country that has seen fewer than 50 cases of donated organs in just under a decade. 'Doctors in Japan are happy with their patients being on dialysis because it is profitable,' Mr Hokamura said. 'They get 5.1 million yen a year to treat people like me.' Sources say the cost of a kidney transplant in China runs to US$66,500 and a liver transplant up to US$157,000. Mr Hokamura said he paid another US$8,400 for transport costs. He negotiated the deal through a Japanese broker in Shenyang called the International Transplantation Network Assistance Centre. Calls to the centre were answered by a Japanese-speaking Chinese secretary who handed over to a man identifying himself as Dr Mitamura. 'We cannot talk to the press because we had media attention last year which caused problems,' he said. The centre has attracted the attention of a growing number of Japanese media organisations and was recently filmed by a network TV crew. Dr Mitamura said his colleagues would discuss money only after a return address and telephone number in Japan were provided. Several other Japanese groups have travelled to China to investigate the trade, including the Japan Transplant Recipients' Organisation, a non-profit organisation support group that lobbies for legal changes to increase the number of donors. 'We don't approve of receiving organs from executed prisoners but personally I can't simply disapprove of it,' said chairman Masanori Suzuki. 'There are just too few donors in Japan.' Last May, Mr Suzuki visited a hospital in a 'major city' and found that 95 per cent of its transplant patients had received organs from executed prisoners. The hospital had conducted 2,000 organ transplants last year alone, Mr Suzuki said. About 30 or 40 were Japanese and 200 were Korean. 'For many patients, this is their last chance.' Although Beijing does not reveal how many people are executed annually, Amnesty International put the figure at 3,400 in a 2004 survey. Some analysts say it is as high as 8,000. Since the 1980s, organ harvesting requires the consent of the prisoners or their families but there is some doubt whether consent is always granted. After it was revealed that Japanese and Malaysians had died from botched Chinese organ transplants, the central government insisted it had moved to regulate them. 'In respect to organ transplants, China has rigorous laws and regulations,' Foreign Ministry spokesman Qin Gang said. 'Donors, recipients and hospitals must all firmly follow laws and regulations in this area.' The Japanese Health Ministry has begun a joint research project with transport authorities in a bid to better monitor the trade. But the Japanese government is likely to find it difficult to stop desperate people who have money from making the short trip to China. As Mr Hokamura said: 'I was on dialysis for four years. I was tired of waiting.'