Outcome of overseas commercial kidney transplantation: an Australian perspective

Kennedy, Seán; Shen, Y.G.; Charlesworth, J. A.; Mackie, James; Mahony, John D; Kelly, John J.; Pussell, Bruce A.

doi:10.5694/j.1326-5377.2005.tb06671.x

Cited by 82 publications

(50 citation statements)

References 16 publications

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“…According to Kennedy and colleagues, 5 patient of 16 died during the course of overseas KT, and concluded that the patient and graft survival were worse than KT within Australia (4). Similar concern was raised concerning LT, where 1 and 5 yr survival rate was lower among overseas LT recipients (90% and 77% vs 93% and 93%) (14).…”

Section: Discussionmentioning

confidence: 99%

“…Alghamdi reported that overseas KT patients had a higher percentage of acute rejection compared to the patients transplanted within Saudi Arabia (27.9% vs 9.9%, P = 0.005) (17). Others have described a higher rate of fungal, CMV, HIV, or hepatitis B or C infection, or urological complication among overseas KT recipients (4, 9, 15-18). According to our data, KT recipients experienced a relatively high postoperative complication rate of 42.5%, with infection as the most common cause.…”

Section: Discussionmentioning

confidence: 99%

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Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Kwon

Lee

2011

J Korean Med Sci

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The disparity between patients awaiting transplantation and available organs forced many patients to go overseas to receive a transplant. Few data concerning overseas transplantation in Korea are available and the Korea Society for Transplantation conducted a survey to evaluate the trend and outcome of overseas transplantation. The survey, conducted on June 2006, included 25 hospitals nationwide that followed up patients after receiving kidney transplant (KT) or liver transplant (LT) overseas. The number of KT increased from 6 in 2001 to 206 in 2005 and for LT from 1 to 261. The information about overseas transplant came mostly from other patients (57%). The mean cost for KT was $21,000 and for LT $47,000. Patients were admitted for 18.5 days for KT and 43.4 days for LT. Graft and patient survival was 96.8% and 96.5% for KT (median follow up 23.1 months). Complication occurred in 42.5% including surgical complication (5.3%), acute rejection (9.7%) and infection (21.5%). Patient survival for LT was 91.8% (median follow up 21.2 months). Complication occurred in 44.7% including 19.4% biliary complication. Overseas KT and LT increased rapidly from 2001 to 2005. Survival of patients and grafts was comparable to domestic organ transplantation, but had a high complication rate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Kwon

Lee

2011

J Korean Med Sci

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“…However, it is fraught with both clinical and public health implications. Apart from the standard of hygiene and quality of postoperative care in overseas centers, recipients have been reported to have contracted infections endemic to overseas centers (e.g., tuberculosis, aspergillus, and hepatitis B) or even donor malignancies [29–31]. Medical records from overseas centers are often incomplete, scant, in a foreign language, or unobtainable [29, 32, 33].…”

Section: Discussionmentioning

confidence: 99%

“…Apart from the standard of hygiene and quality of postoperative care in overseas centers, recipients have been reported to have contracted infections endemic to overseas centers (e.g., tuberculosis, aspergillus, and hepatitis B) or even donor malignancies [29–31]. Medical records from overseas centers are often incomplete, scant, in a foreign language, or unobtainable [29, 32, 33]. Fatal postoperative bleeding has also been reported, as have both under or over-immunosuppresion, and infection with the HIV virus [29, 30, 32, 34, 35].…”

Section: Discussionmentioning

confidence: 99%

“…Medical records from overseas centers are often incomplete, scant, in a foreign language, or unobtainable [29, 32, 33]. Fatal postoperative bleeding has also been reported, as have both under or over-immunosuppresion, and infection with the HIV virus [29, 30, 32, 34, 35]. Renal transplant tourists have been reported to have a more complex posttransplantation course with a higher incidence of graft rejection and severe infectious complications [36].…”

Section: Discussionmentioning

confidence: 99%

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Chronic Hepatitis E Infection Resulting in Graft Failure in a Liver Transplant Tourist

Tan

Leong

Tan

et al. 2011

Case Reports in Transplantation

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The dilemma and reality of transplant tourism: An ethical perspective for liver transplant programs

Schiano

2010

Liver Transpl

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Transplant programs are likely to encounter increasing numbers of patients who return after receiving an organ transplant abroad. These patients will require ongoing medical care to monitor their immunosuppression and to provide treatment when the need arises. Transplant societies have condemned transplantation with organs purchased abroad and with organs procured from executed prisoners in China. Nevertheless, transplant programs require guidance on how to respond to the needs of returning transplant tourists and to the needs of patients who may choose to become transplant tourists. This discussion presents a case that raised such issues in our program. It goes on to offer reasons for considering a program's responses in terms of the most relevant principles of medical ethics, namely beneficence and nonjudgmental regard. This is the first in a series of case-based discussions of ethical dilemmas facing liver transplant programs and physicians. In caring for extremely ill patients with complex medical problems, liver transplant teams are on the front line when it comes to making difficult decisions. Many such decisions are made during meetings of the program's recipient review committee, a forum that seeks perspectives from a variety of professionals, including transplant coordinators, social workers, psychiatrists, and medical/surgical subspecialists. At times, however, a clear consensus on whether or not to perform transplantation for a patient may be difficult to obtain. What follows is such a case that we encountered at our center. THE CASEH.Q., a 46-year-old Chinese accountant, was placed on the liver transplant waiting list with a Model for EndStage Liver Disease score of 18 and an O blood type. He had hepatitis C with refractory ascites requiring biweekly paracentesis, type 2 hepatorenal syndrome, and hepatic encephalopathy. He had no potential live donor and no close family living outside the New York City area, and he did not want to consider dual listing outside United Network for Organ Sharing (UNOS) region 9. After he had waited on the list for a year, his Model for End-Stage Liver Disease score had risen to 21, and he had received no donor calls despite several recent hospitalizations. H.Q. was then unable to be contacted for several weeks, and a family member subsequently told us that he had undergone liver transplantation in China. Friends had suggested that he travel to China, where he could obtain a liver transplant for a fee. He then investigated the option through relatives in China and made the necessary arrangements to stay with them. He received a liver transplant 2 weeks after arriving in China.Three months after his liver transplant, H.Q. returned to our program, requesting follow-up care. He explained that he had received a liver transplant in China, but when questioned, he stated that he knew nothing about the source of the transplanted organ. He came with scant medical records and was about to run out of the immunosuppressive medication that he had been given by the transplant center i...

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Outcome of overseas commercial kidney transplantation: an Australian perspective

Cited by 82 publications

References 16 publications

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

Chronic Hepatitis E Infection Resulting in Graft Failure in a Liver Transplant Tourist

The dilemma and reality of transplant tourism: An ethical perspective for liver transplant programs

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