Liver Transplant Tourism

Abstract

Liver transplant tourism is travel for transplantation involving organ trafficking and/or transplant commercialism. Various medical, financial, and organizational factors play a role in transplant care including waiting lists, Model for End-Stage Liver Disease scores, and financial aid. We outline the international experiences with transplant tourism (TT) and its effect on their medical communities and patients. For clinicians providing care to patients involved in TT, we also discuss pretransplant counseling and posttransplant care. Liver Transplantation 26 276-282 2020 AASLD. liveR tRAnsplAntAtion, vol. 26, no. 2, 2020 Hindi et Al. Review ARticle | 277 TT ReformAt the Declaration of Istanbul (DoI) summit in 2008, international transplant researchers and politicians defined specific acts related to the process of illegal organ transplantation. The DoI acknowledged TT and provided ethical and social transplant guidelines for individual countries in an effort to curb TT. Moreover, the differences in definitions for travel for transplantation and TT were distinguished. Travel for transplantation is the movement of organs, donors, recipients, or transplant professionals across jurisdictional borders Zaid Hindi and Mayur Brahmania were responsible for the study concept and design and for drafting the manuscript.

Meta-analysis of donor–recipient gender profile in paediatric living donor liver transplantation

“…The use of GDI grouping might have led to overgeneralisation as there exist regional variations in healthcare resources, disease profile and socioeconomic status within the same country. Finally, transplant tourism, which is likely to be grossly underestimated and is known to take place to some degree in at least four of the countries in our review, further confounds accurate data analysis 21…”

Why are there so many liver transplants from living donors in Asia and so few in Europe and the US?

“…Patients from countries where LT is unavailable preferentially come to these eastern countries, which in turn increases the throughput of LDLT. Overseas patients benefit from the quality, excellent results and cost effective aspects of treatment in these countries [7,10] . Other important aspect are the infrastructural mandates of LDLT and DDLT units.…”

“…It however disheartening to note that there still remains a grey area. There are reports from independent agencies which suggest that some of the data may be falsified, and apparently non-voluntary donors are misclassified as voluntary; spawning a belief in some quarters that the trust may have been violated and that the reputations of these Chinese professionals dedicated to the highest standard of transplant medicine may be impugned [10,[13][14][15] . An all-inclusive state-run healthcare system with modernised public sector hospitals would solve the problem of economic inequity and provide universal access to health [16] .…”

Infectious disease complications of transplant tourism

“…[2] Documentation from the transplant center and infection prophylaxis may be incomplete or nonexistent. [6] Infectious disease testing upon return to their home country may enhance safety (Table 1), along with initiation of infection prophylaxis (depending on time after transplant and local protocols). For those recipients who are ill upon return, consultation with infectious diseases specialists with familiarity in both geographic medicine and immunocompromised hosts would be essential.…”

“…Ensuring these recipients are accepted back to the transplant centers where they live is crucial for optimal outcomes. [6] A…”