Transplant tourism—an update regarding the realities

[Clark]

http://www.nature.com/nrneph/journal/v7/n5/pdf/nrneph.2011.40.pdf

Transplant tourism—an update regarding the realities
Francis L. Delmonico
A recent article exposes the ongoing industry of transplant tourism in China, where foreign patients can receive vendor organs recovered from executed prisoners. Concerning data reveal the long-term complications of kidney transplant tourism, particularly the increased risk of malignancy. These findings relay an important message to transplant communities and physicians worldwide.

Delmonico, F. L. Nat. Rev. Nephrol. 7, 248–250 (2011); doi:10.1038/nrneph.2011.40

A paper published recently in Kidney International draws attention to the practice of transplant tourism from Taiwan to mainland China, where transplant tourists receive vendor organs that have been recovered from executed prisoners. The authors evaluated medical records of 215 Taiwanese patients who underwent commercial transplantation in China, comparing their outcomes with those of a cohort of domestic transplant recipients who received legitimate renal transplants from deceased donors in Taiwan over the same time period. The graft and patient survival rates were better for the domestic group than for the tourist group 10 years after transplantation, but the differences between the groups were not statisti- cally significant. However, the authors focus on transplant tourism as an independent risk factor for post-transplantation malignancy—attributed to the tourist recipients generally being older, to induction immunosuppressive treatment as a factor contributing to malignancy, and to the absence of, or inadequacy of, pretransplantation cancer screening of the donor.

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The experience of centers in the care of transplant tourists must continue to be reported in the medical literature to provide revealing information and affirm an international standard—that transplant tourism is not ultimately advantageous for the patient or acceptable to the physician accountable for medical care.