New Zealanders in desperate need of organ transplants may be forced to consider illegal options as the country's donation rate remains low, research suggests.

University of Canterbury (UC) lecturer Eric Crampton today said New Zealand had the third-lowest organ donation rate in the developed world after Greece and Mexico.

He said the country needed to increase its transplant rate to ''save lives and reduce costs'' on the health system.

About 600 Kiwis are on the waiting list for organ transplants, mostly for kidneys. Last year there were 57 live donors and 38 deceased donors.

Crampton said there were ''few reasons'' for the country's low organ donation rate but the system was not working well.

''Because the driver's licence scheme does not constitute informed consent, doctors feel the need to seek explicit family permission at what is the worst possible time for families to be making that kind of decision.''

He said New Zealand's system allowed the deceased person's wishes to be ''overturned by family and friends''.

Spain had the highest rate of organ donation because people were presumed to be organ donors unless they stated otherwise before their death.

New Zealand's organ donor rate was 8.7 per million in the latest figures, compared with Spain's 32 per million rate.

UC master's student Rachel Walsh is investigating organ trafficking and said that because there was a ''severe shortage'' of organs in New Zealand, people were looking at illegal options because they were so desperate.

''One of the more popular trends is to obtain an organ through transplant tourism, which is where potential organ recipients travel to another country to receive an organ transplant.''

Hot spots for transplant tourism included China, the Philippines and Pakistan.

She said many companies offering transplant tourism packages were disguised as internet companies selling T-shirts and pens, or even as joke websites.

There had been no reported cases in New Zealand of prosecution for buying and selling transplantable organs but this did not mean people were not buying organs overseas.

''Sadly, the number of people who need organs is growing and the transplant waiting lists are getting longer. With this in mind, it is understandable why people are turning to illegally purchased organs from overseas.''

Walsh said the donor pool needed to be increased in New Zealand so people were not forced to break the law.

Christchurch woman Cherry Milne received a kidney transplant about 20 years ago and said she was ''very aware'' of New Zealanders trying to buy organs overseas.

''It's pretty common, but I don't know anyone who has bought an organ successfully. The other sad thing is when people are on the waiting list for so long that they just give up. They go off dialysis and die.''

Milne said that if waiting lists continued to grow, ''more and more desperate people'' would consider illegal options.

- © Fairfax NZ News

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