The lack of cadaver organs for transplantation motivates some Balkan patients to go to developing countries to buy a kidney. We have followed 36 patients who received kidney transplants in Lahore and Rawalpindi, Pakistan. The patients had not been cleared for transplantation with a standard pre-transplant work-up: 80% were hepatitis-C virus (HCV) or HBsAg positive. During follow-up, seven patients died. Sixteen patients experienced wound infections with post-operative hernias, and three patients developed peri-renal hematomas. Six abscesses and four lymphoceles occurred, and four urinary fistulas were surgically treated. Nephrectomy was performed in three patients because of renal artery thrombosis. Nine patients developed active hepatitis C, and four patients manifested cytomegalovirus disease. Three patients developed steroid diabetes, and three patients experienced acute myocardial infarction. Nine patients had one or more rejection episodes. Urinary tract infection with Pseudomonas or Escherichia occurred frequently. The one-yr patient and graft survival rates were 80% and 68%, respectively. Paid unregulated renal transplantation is not recommended for both ethical reasons and because of an association with excessive morbidity and mortality. © 2010 John Wiley & Sons A/S.

Transplant tourism Renal transplantation Complications Commercialism

cytomegalovirus infection Pakistan kidney donor wound infection renal artery thrombosis urinary tract infection survival rate Follow-Up Studies human Developing Countries middle aged lymphocele priority journal Hepatitis C virus Aged death chronic allograft nephropathy urine incontinence Hepatitis B virus Postoperative Complications Young Adult Humans Adolescent graft survival male female hernia clinical article kidney abscess Outcome Assessment (Health Care) Escherichia Article perirenal hematoma kidney transplant tourism hepatitis B antigen Kidney Diseases Pseudomonadaceae adult Kidney Transplantation medical tourism hematoma Nephrectomy outcome assessment urinary tract fistula acute heart infarction postoperative complication sepsis hepatitis B kidney graft rejection Hepacivirus hepatitis C