Nonrelated Living-Donor Kidney Transplantation: Medical and Ethical Aspects

Abstract

Several patients with end-stage renal disease went to Bombay for renal transplantation from nonrelated living donors and then returned to Turkey for posttransplantation follow-up. The aims of this study are to evaluate the long-term results of renal transplantation from nonrelated living donors in Turkish patients with end-stage renal disease and to discuss the ethical and social aspects of nonrelated kidney donation. One hundred and twenty-seven patients (89 males, 38 females; mean age 38.1, range 17–63 years) were investigated retrospectively. None of the patients went to Bombay on our advice. All transplantations were performed between 1991 and 1995. The mean follow-up period after transplantation was 34.2 (range 1–68) months. Graft survival rates were 85, 83, and 57% after 3 months and 1 and 5 years, respectively. Patient survival rates were 94, 93, and 92% after 3 months and 1 and 5 years, respectively. Seven patients died within the first 3 months after the transplantation. Surgical problems, infections, acute rejection, ciclosporin nephrotoxicity, and hepatic problems were common complications. We conclude that medical and surgical complications occur frequently in paid kidney transplantation, but most of these complications can be prevented by adequate preoperative management, and precautionary measures should be taken to prevent commercialization of renal transplantation before the spread of emotionally related living kidney donation.

Outcomes of Renal Transplantation in Brunei Darussalam over a Twenty-Year Period (1993–2012)

“…Similar results also stemmed from studies from Saudi Arabia [ 11 ], Iran [ 12 , 13 ], and Republic of Korea [ 14 ]. However, studies from Turkey [ 15 , 16 ] and Pakistan [ 17 ] showed inferior rates of patient and graft survival with high rates of complications. Table 4 summarises the graft and patient survival between commercialised and noncommercialised transplants in studies with >100 patients in the last twenty years.…”

The state of the international organ trade: a provisional picture based on integration of available information

“…[30][31][32][33][34][35][36][37][38][39][40][41][42] In some studies, mostly those based on small data sets, patient survival and graft survival rates are considerably lower than the internationally accepted standard; in other studies, they are shown to be comparable with local results. Confounding factors -e.g.…”

“…[30][31][32][33][34][35][36][37][38][39][40][41] Moreover, one study from the United Kingdom reports that patients who had been suspended from the local transplant list for medical reasons were operated on abroad. 33 These factors seem to indicate the existence of substandard medical practices.…”

The changing paradigm of ethics in uterus transplantation: a systematic review

“…However, uteruses are sourced from donors who no longer wish to childbear and, therefore, have exhausted their function. Nevertheless, living donations are fraught with the potential for commercial sale of organs . This concern is highlighted by the appearance of the subtheme of black market trade (nonmaleficence) in our results.…”