Clinical Journal of the American Society of Nephrology
Volume 3, Issue 6, 2008, Pages 1820-1828

Transplant tourism in the United States: A single-center experience (Article) (Open Access)

Gill J.* , Madhira B.R. , Gjertson D. , Lipshutz G. , Cecka J.M. , Pham P.-T. , Wilkinson A. , Bunnapradist S. , Danovitch G.M.
  • a Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States, Division of Nephrology, St. Paul's Hospital, University of British Columbia, 602-1160 Burrard Street, Vancouver, BC V6Z 2E8, Canada
  • b Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  • c UCLA Immunogenetics Center, Los Angeles, CA, United States
  • d Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  • e UCLA Immunogenetics Center, Los Angeles, CA, United States
  • f Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  • g Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  • h Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
  • i Division of Nephrology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States

Abstract

Background and objectives: Transplant "tourism" typically refers to the practice of traveling outside the country of residence to obtain organ transplantation. This study describes the characteristics and outcomes of 33 kidney transplant recipients who traveled abroad for transplant and refumed to University of California Los Angeles (UCLA) follow up. Design, settings, participants, & measurements: Posttransplantation outcomes were compared between tourists and a matched cohort of patients who underwent transplantation at UCLA (matched for age, race, transplant year, dialysis time, previous transplantation, and donor type). Median follow-up time was 487 d (range 68 to 3056). Results: Compared with all patients who underwent transplantation at UCLA, tourists included more Asians and had shorter dialysis times. Most patients traveled to their region of ethnicity with the majority undergoing transplantation in China (44%), Iran (16%), and the Philippines (13%). Living unrelated transplants were most common. Tourists presented to UCLA a median of 35 d after transplantation. Four patients required urgent hospitalization, three of whom lost their grafts. Seventeen (52%) patients had infections, with nine requiring hospitalization. One patient lost her graft and subsequently died from complications related to donor-contracted hepatitis B. One-year graft survival was 89% for tourists and 98% for the matched UCLA cohort (P = 0.75). The rate of acute rejection at 1 yr was 30% in tourists and 12% in the matched cohort. Conclusions: Tourists had a more complex posttransplantation course with a higher incidence of acute rejection and severe infectious complications. Copyright © 2008 by the American Society of Nephrology.

Author Keywords

[No Keywords available]

Index Keywords

living donor Living Donors Tissue Donors donor human risk assessment Communicable Diseases middle aged Delayed Graft Function travel comparative study Time Factors ethnology Tissue and Organ Procurement United States transplantation Humans graft rejection Treatment Outcome graft survival male California female Article Retrospective Studies communicable disease adult Kidney Transplantation retrospective study time
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-58149335158&doi=10.2215%2fCJN.02180508&partnerID=40&md5=79113d294990e5b6a6d0041141a13a9d
DOI: 10.2215/CJN.02180508
ISSN: 15559041
Cited by: 76
Original Language: English