Outcome of living unrelated (commercial) renal transplantation: report of 20 cases

Hamida, F. Ben; Abdallah, T. Ben; Goucha, R.; Hedri, H.; Helal, Imed; Karoui, C.; Abderrahim, E.; Moussa, F. Ben; Kheder, A.; Maı̈z, H. Ben

doi:10.1016/s0041-1345(01)02136-4

Cited by 16 publications

(13 citation statements)

References 11 publications

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“…[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.…”

Section: Consequences and Effectsmentioning

confidence: 99%

See 1 more Smart Citation

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

Shimazono¹

2007

Bull World Health Organ

310

196

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Section: Consequences and Effectsmentioning

confidence: 99%

“…[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.…”

Section: Consequences and Effectsmentioning

confidence: 99%

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

Shimazono¹

2007

Bull World Health Organ

310

196

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“…Ben Hamida et al [28] studied 20 patients who received renal transplant overseas; 14 patients received their transplant in Iraq and 3 each in Egypt and Pakistan. Graft survival rates were comparable to those of living-related transplant and better than those of cadaveric transplant in Tunisia.…”

Section: Critique Of Literaturementioning

confidence: 99%

Commercialization of Kidney Transplants: A Systematic Review of Outcomes in Recipients and Donors

Sajjad

Baines²,

Patel³

et al. 2008

Am J Nephrol

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In this study we systematically reviewed outcomes in recipients and donors of commercial kidney transplants. Inherent in a study of this nature is the possibility of center and country bias, in particular there are no publications from China and South America. Publications also tended to report poor outcomes which may reflect bias on the part of the authors or to highlight the ethical issues in this area. We were unable to perform a meta-analysis due to variability in studies making it impossible to synthesize the data other than descriptive. Furthermore, these studies were not large or well conducted. We found that patient and graft survival was generally inferior to the data obtained from the UNOS (United Network for Organ Sharing). Some studies did achieve good outcomes, however, due to lack of details, it was not possible to infer if the donor hospital, surgical technique or immunosuppressive regimen was a factor. There was a higher incidence of unconventional and life-threatening infections such as malaria, invasive fungal infections, pneumonia, HIV and hepatitis. There was also a markedly increased incidence of postoperative surgical interventions in recipients. We suggest the establishment of a database for both recipients and donors to identify unique surgical, medical, infectious and immunosuppressive protocols for the recipients and donors in these hospitals. This could lead to better liaison between the recipient and donor hospitals so that modern surgical and medical practices can be implemented. There should also be improved emotional and psychological support to both the recipient and the donor. However, these steps could be seen as condoning the reprehensible practice of commercialization of human body parts.

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“…They sell their kidneys to earn freedom from bondage or pay off their loans [3]. Unlike the foreign tourists who return home and are cared for in specialist centers [4–7], local vended kidney recipients often find themselves unable to obtain specialist care and proper follow‐up, especially in case of complications requiring hospitalization. They present themselves at our Institute, a tertiary care center, which offers dialysis, living‐related transplant and immunosuppressive drugs to all our patients free of cost [8].…”

Section: Introductionmentioning

confidence: 99%

Commercial transplants in local Pakistanis from vended kidneys: a socio-economic and outcome study

Rizvi

Naqvi

Zafar

et al. 2009

Transplant International

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Summary Donor shortage and absence of transplant law lead to unrelated commercial transplants in Pakistan. We report the socio‐economic and outcome parameters of 126 local recipients of unrelated kidney vendor transplants presenting to our institute between 1997 and 2007. Their outcome was compared with 180 recipients of living‐related donor transplants matched for age, gender and transplant duration as controls. Age of commercial recipients was 35.63 ± 11.57 years with an M:F ratio of 2.4:1. Majority (92%) were transplanted in northern Pakistan paying US$7271 ± 2198. All were educated with 50% being graduates or above and rich earning a monthly salary of US$517 ± 518 with 44% earning >US$500. Comparison of commercial recipients with controls showed high comorbidities 35 (28%) vs. 14 (8%) (P = 0.0001) with diabetes, hepatitis‐C and cardiovascular diseases. Donor age was 29.97 ± 6.16 vs. 32.63 ± 9.3 years (P = 0.035). Biologic agents induction in 101 (80%) vs. 14 (8%) (P = 0.0001), acute rejections in 42 (33%) vs. 31 (17%) (P = 0.005), 1‐year creatinine 1.84 ± 1.28 vs. 1.27 ± 0.4 mg/dl (P = 0.0001), surgical complications 28 (22%) vs. 14 (8%) (P = 0.001), tuberculosis 14 (11%) vs. 6 (6%) (P = 0.007), acute hepatitis 20 (16%) vs. 3 (2%) (P = 0.0001), cytomegalovirus 33 (26%) vs. 21 (11%) (P = 0.001) and recurrent urinary tract infection 35 (28%) vs. 30 (16%) (P = 0.034). Overall 1‐ and 5‐year graft survival was 86% and 45% vs. 94% and 80%, respectively (P = 0.00001). Total deaths were 34 (27%) vs. 12 (6.0%) (P = 0.001). In conclusion, recipients of the vended kidneys are poor candidates, educated, rich and often self‐selecting. Their outcome is poor, which will leave them poorer still and back to dialysis if not death.

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Outcome of living unrelated (commercial) renal transplantation: report of 20 cases

Cited by 16 publications

References 11 publications

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

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

Commercialization of Kidney Transplants: A Systematic Review of Outcomes in Recipients and Donors

Commercial transplants in local Pakistanis from vended kidneys: a socio-economic and outcome study

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