Low costs and high availability brought in business from around the globe, and transformed India into one of the largest kidney transplant centers in the world.[31] However, several problems began to surface. In some cases, patients were unaware that a kidney transplant even took place.[32] In other cases, patients were promised payments that were much higher than what they actually received.[33] These and other ethical issues pushed the Indian government to pass legislation banning the sale of organs.[34] Nevertheless, current laws still contain loopholes. For example, the THOA states that an organ donor must be a relative, spouse, or an individual donating for reasons of "affection" for the recipient.