Nephrology
Volume 16, Issue 7, 2011, Pages 672-679

Long-term outcomes of kidney allografts obtained by transplant tourism: Observations from a single center in Korea (Article)

Cha R.-H. , Kim Y.C. , Oh Y.J. , Lee J.H. , Seong E.Y. , Kim D.K. , Kim S. , Kim Y.S.*
  • a Department of Internal Medicine, National Medical Center, South Korea
  • b Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea
  • c Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea
  • d Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea
  • e Department of Internal Medicine, Pusan National University College of Medicine, Busan, South Korea
  • f Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea
  • g Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea, Kidney Research Institute, Seoul National University Medical Research Center, Seoul, South Korea
  • h Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehang-ro, Jongno-gu, Seoul 110-744, South Korea, Kidney Research Institute, Seoul National University Medical Research Center, Seoul, South Korea

Abstract

Aim: Organ shortages lead end stage renal disease patients to seek overseas kidney transplantations (OTs), but the long-term outcomes of OTs have not been evaluated extensively. Methods: Patients who received OT and were followed at Seoul National University Hospital (SNUH) from 2000 to 2009 (n = 87) were compared with patients who received kidneys from local donors (LTs) and were followed at SNUH (n = 577). Furthermore, we matched OT patients and LT patients via a propensity score using operation date, age, renal replacement therapy duration, and donor sources (n = 87 vs 87). Results: The recipient age was older in the OT group (48 vs 41 years), and donor age was younger in the OT group (29 vs 39 years). The estimated glomerular filtration rates (eGFR) of functioning grafts between the groups were not different throughout the follow-up period. Biopsy-proven acute rejection, infectious disease, and hospitalization were more frequent in the OT group (27/87 vs 141/577, log-rank P < 0.001; 39/87 vs 28/577, log-rank P < 0.001; 66/87 vs 99/577, log-rank P < 0.001). The graft survival rate was lower in the OT group (82/87 vs 542/577, log-rank P = 0.003). Patient survival rate, however, was similar between the groups. After propensity score matching, the donor age was still younger in the OT group (29 vs 38 years). The risks of biopsy-proven acute rejection, infectious disease, and hospitalization were still higher in the OT group (27/87 vs 36/87, log-rank P = 0.04; 39/87 vs 3/87, log-rank P < 0.001; 66/87 vs 19/87, log-rank P < 0.001). Conclusion: Overseas kidney transplantation connotes risk factors that may negatively affect the long-term graft outcome. Cha et al. discuss the risks associated with transplant tourism. They present their data on individuals returning to their Korean centre with transplants acquired overseas. These transplants showed inferior long-term graft outcomes with an increase in the risk of infection, surgical complications, hospitalization, and graft loss. © 2011 Asian Pacific Society of Nephrology.

Author Keywords

Outcome transplantation tourism Kidney transplantation

Index Keywords

Glomerular Filtration Rate South Korea hospitalization Republic of Korea kidney donor Kaplan-Meier Estimate Proportional Hazards Models Tissue Donors survival rate tourism acute graft rejection follow up human risk assessment Communicable Diseases middle aged priority journal Time Factors transplant tourism Logistic Models biopsy Humans kidney allograft graft rejection Hospitals, University Treatment Outcome graft survival male Chi-Square Distribution female risk factor Risk Factors Transplantation, Homologous kidney allograft rejection Article major clinical study adult Kidney Failure, Chronic propensity score medical tourism Kidney Transplantation outcome assessment infection
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-80052086904&doi=10.1111%2fj.1440-1797.2011.01480.x&partnerID=40&md5=8591bfa4b905c0c5ee0839314b3e8984
DOI: 10.1111/j.1440-1797.2011.01480.x
ISSN: 13205358
Cited by: 14
Original Language: English