Transplant tourism increases health-related risks for organ recipients

Traveling abroad to receive a kidney from a paid living donor at a commercial transplant center carries considerable risks, according to a study that will be presented at ASN Kidney Week 2015 Nov. 3-8 at the San Diego Convention Center in San Diego, CA.

While the ethical aspects of transplant tourism—when patients travel abroad to purchase organs for transplants—have received much attention recently, less has been written about the medical safety of this practice. To assess this, investigators in Bahrain retrospectively evaluated the health outcomes of patients who purchased organs internationally and then came to their medical center for follow-up care between 1986 and 2014.

The study included 270 transplant recipients who were compared with 123 recipients of living related donor transplants. Among the 270 "commercial" recipients, the top 3 countries where patients underwent transplantation were the Philippines, India, and Pakistan. Compared with controls, commercial recipients were more likely to develop hepatitis C, hepatitis B, and cytomegalovirus, and they were more likely to experience acute and recurrent rejections and surgical complications. Overall 1-and 10-year survival rates of the transplanted organs in commercial recipients compared with controls were 91% and 22% vs. 98% and 44%. Corresponding patient survival rates were 96% and 70% vs. 98% and 78%.

"The data are consistent with other reports," said Francis Delmonico, MD, who was not involved with the study and is the Executive Director of the Declaration of Istanbul Custodian Group. The Declaration was created in 2008 by an international team of experts to define organ trafficking, transplant tourism and commercialism, and achieve consensus regarding principles of practice and recommended alternatives to address the shortage of organs.