Obtaining kidney transplants abroad carries certain medical risks

Oct 15, 2008

People traveling to other countries to receive kidney transplants experience more severe post-transplant complications with a higher incidence of acute rejection and severe infections, according to a study appearing in the November 2008 issue of the Clinical Journal of the American Society Nephrology (CJASN). The findings suggest that such "transplant tourism" by Americans may not be as safe as receiving transplants in the United States.

As the demand for kidney transplantation continues to increase, some patients needing a transplant have looked abroad for available organs. While this practice appears to be increasing in the United States, there is little available information regarding its safety.

To investigate the issue, Jabir Gill, MD, of the David Geffen School of Medicine at the University of California, Los Angeles (UCLA), and his colleagues studied the outcomes of kidney transplant recipients who were US residents that traveled abroad for transplants and returned to UCLA for follow-up care. They compared these so called "transplant tourists" with similar patients who underwent both transplantation and follow-up care at UCLA.

The study included 33 transplant tourists and 66 UCLA-transplanted patients who were followed for an average of 16 months. The investigators noted that most transplant tourists traveled to their region of ethnicity with the majority receiving transplants in China (44%), Iran (16%), and the Philippines (13%). After receiving their transplants, tourists came to UCLA for follow-up about a month after their procedure.

After one year, kidney rejection occurred in 30% of tourists compared with 12% of the UCLA-transplanted patients. The incidence of infections was not significantly different between tourists and UCLA-transplanted patients, but the severity and types of infections were markedly different. Seventeen tourists (52%) had at least one infectious complication, with three patients having had two or more infectious episodes. Nine patients (27%) were hospitalized with an infection listed as the primary cause of hospitalization. By comparison, only six (9%) of the 66 UCLA-transplanted patients required hospitalization for infectious complications following transplantation. One patient in the transplant tourism group died from complications related to possibly donor-contracted hepatitis B. The investigators also noted that infections with cytomegalovirus were more common among tourists than UCLA-transplanted patients.

The authors noted that the higher incidence of infectious complications may reflect a number of issues relating to tourism, including difficulties maintaining and monitoring immunosuppression during the transition of care abroad to facilities at home, the lack of preventive care for infections early after transplantation, the varying infectious disease characteristics of different countries, and the unclear means of selecting donors in many of these cases.

According to the authors, this study's findings indicate that "transplant tourism is a risky option for patients awaiting kidney transplantation and its implications on public health warrant further evaluation."

The article, entitled "Transplant Tourism in the United States: A Single Center Experience," will appear online at cjasn.asnjournals.org/ on October 15, 2008, and in the November 2008 print issue of CJASN.

Source: American Society of Nephrology

Explore further: ALS Ice Bucket Challenge arrives in North Korea

add to favorites email to friend print save as pdf

Related Stories

Transplant tourism poses ethical dilemma for US doctors

Jan 26, 2010

A recent case study by doctors at Mount Sinai Hospital in New York examined the ethical issues posed by transplant tourism, an offshoot of medical tourism, which focuses solely on transplantation surgery. Many American transplant ...

Recommended for you

Surrogate offers clues into man with 16 babies

6 hours ago

When the young Thai woman saw an online ad seeking surrogate mothers, it seemed like a life-altering deal: $10,000 to help a foreign couple that wanted a child but couldn't conceive.

Nurses go on strike in Ebola-hit Liberia

6 hours ago

Nurses at Liberia's largest hospital went on strike on Monday, demanding better pay and equipment to protect them against a deadly Ebola epidemic which has killed hundreds in the west African nation.

ALS Ice Bucket Challenge arrives in North Korea

Aug 31, 2014

It's pretty hard to find a novel way to do the ALS Ice Bucket Challenge by now, but two-time Grammy-winning rapper Pras Michel, a founding member of the Fugees, has done it—getting his dousing in the center ...

Cold cash just keeps washing in from ALS challenge

Aug 28, 2014

In the couple of hours it took an official from the ALS Association to return a reporter's call for comment, the group's ubiquitous "ice bucket challenge" had brought in a few million more dollars.

Medtronic spends $350M on another European deal

Aug 27, 2014

U.S. medical device maker Medtronic is building stronger ties to Europe, a couple months after announcing a $42.9 billion acquisition that involves moving its main executive offices across the Atlantic, where it can get a ...

User comments : 0