BACKGROUND. Although international commerce in kidney transplantation is a reality, little is known about U.S. residents who travel abroad for kidney transplantation. METHODS. We retrospectively reviewed the clinical outcomes of patients who were evaluated at the University of Minnesota Medical Center or Hennepin County Medical Center, but then surreptitiously underwent kidney transplantation overseas. RESULTS. We identified 10 patients who underwent kidney transplantation outside the United States between September 16, 2002 and June 30, 2006 and then returned for care in our programs. Eight were transplanted in Pakistan (all Somali), one was transplanted in China (Chinese), and one was transplanted in Iran (Iranian). All but one had a living donor. Mean age was 36.8±12.5 years with median follow-up of 2.0 years (range 0.4-3.7). Three patients communicated their intent to travel abroad before transplantation. Induction immunosuppressive therapy (if any) was available in 3/10, and initial maintenance immunosuppression was known in 5/10. Complications were primarily infectious, with six potentially life-threatening infections in four patients. At last follow-up, mean serum creatinine was 1.13±0.34 mg/dL, acute rejection occurred in 2/10, 1/10 grafts failed due to acute rejection, and 9/10 patients were alive. CONCLUSIONS. Kidney function and graft survival were generally good after surreptitious overseas kidney transplantation. Major problems included incomplete perioperative information communicated to the posttransplant care facility and a high incidence of posttransplant infections. Longer follow-up and detailed cost analysis are needed to better understand the implications of the growing phenomenon of transplant tourism. © 2006 Lippincott Williams & Wilkins, Inc.

Transplant tourism Commercial renal transplantation Medical outcomes Kidney transplant

cytomegalovirus infection dialysis China Pakistan Chinese living donor wound infection urinary tract infection tourism survival acute graft rejection follow up immunoglobulin human travel diabetes mellitus priority journal diazepam central nervous system infection erythrocytosis ganciclovir chronic allograft nephropathy OKT 3 humoral immunity valproate semisodium Prednisone Iran maintenance therapy United States insulin health program Humans immunosuppressive treatment Treatment Outcome graft survival male female preoperative period creatinine blood level immunosuppressive agent clinical article Conference Paper commercial phenomena bacterial infection adult Kidney Transplantation interstitial nephritis outcome assessment azathioprine ethnicity sepsis seizure emporiatrics aspergillosis mycophenolic acid 2 morpholinoethyl ester cyclosporin methylprednisolone kidney graft rejection creatinine postoperative infection