Organ trafficking for live donor kidney transplantation in Indoasians resident in the west midlands: high activity and poor outcomes

Transplantation. 2010 Jun 27;89(12):1456-61. doi: 10.1097/TP.0b013e3181da6019.

Abstract

Introduction: Some Indoasian (IA) patients with established renal failure travel abroad for commercial kidney transplantation. We compared the 1-year outcomes of IA patients from one UK region who received overseas transplants with IA patients receiving local living donor (LD) kidney transplantation, deceased donor (DD) transplantation, and dialysis.

Methods: Between 1996 and 2006, 40 adults were transplanted overseas; 38 were IA, and follow-up data were available on 36 patients. Forty IA patients received LD transplants, and 156 patients received DD transplants locally. A cohort of 120 prospective dialysis patients was also used as a comparator group.

Results: In the overseas cohort, 20 patients (56%) were not active in the UK transplant waiting list at the time of kidney transplantation overseas. One-year graft survival was 87%, and 1-year patient survival was 83%. Composite graft and patient survival was 69.5% at 1 year. In the local LD transplant recipients, patient survival was 97.5% (39 of 40; P=0.03), and graft survival was 97.5% (39 of 40; P=0.06). Composite graft and patient survival was 95% (P=0.003). In the overseas group, 42% had major infections compared with 15% in the local group (P=0.02). One-year graft survival for DD transplant was 84.6% (132 of 156), and 1-year patient survival was 93% (145 of 156; P=NS and P=0.06, respectively). In the dialysis group, 1-year patient survival was 96.7% (116 of 120; P=0.001).

Conclusion: IA patients who choose to travel overseas for kidney transplantation have poor clinical outcomes and should be counseled accordingly.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Asia
  • China
  • Cohort Studies
  • Crime
  • Female
  • Graft Survival
  • Humans
  • India
  • Kidney Transplantation / methods*
  • Living Donors
  • Male
  • Middle Aged
  • Renal Insufficiency / therapy*
  • Tissue and Organ Procurement / legislation & jurisprudence
  • Tissue and Organ Procurement / methods*
  • Travel
  • Treatment Outcome
  • United Kingdom