Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2021; 13(7): 717-722
Published online Jul 27, 2021. doi: 10.4254/wjh.v13.i7.717
Current state of medical tourism involving liver transplantation-the risk of infections and potential complications
Ritesh Neupane, Pahnwat Tonya Taweesedt, Humayun Anjum, Salim Surani
Ritesh Neupane, Department of Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, PA 17033, United States
Pahnwat Tonya Taweesedt, Department of Medicine, Corpus Christi Medical Center, Corpus Christi, TX 78412, United States
Humayun Anjum, Department of Medicine, University of North Texas, Corpus Christi, TX 78412, United States
Salim Surani, Department of Medicine, Texas A&M University, College Station, TX 77843, United States
Author contributions: Neupane R contributed to the manuscript drafting; Taweesedt PT contributed to the revision of the article; Anjum H contributed to the review of the article; Surani S contributed to the idea, and final revision of the article.
Conflict-of-interest statement: Nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, FACC, FACP, FCCP, MD, Professor, Department of Medicine, Texas A&M University, Veterinary Medical Sciences Building, 400 Raymond Stotzer Pkwy, College Station, TX 77843, United States. srsurani@gmail.com
Received: February 14, 2021
Peer-review started: February 14, 2021
First decision: March 16, 2021
Revised: March 29, 2021
Accepted: July 2, 2021
Article in press: July 2, 2021
Published online: July 27, 2021

Liver transplant has been shown to significantly improve mortality and quality of life in various liver diseases such as acute liver failure, end-stage liver disease, and liver cancer. While the organ transplant demand is continuing to rise, the organ donation supply remains unmatched. The organ shortage, high cost, and long waiting lists have stimulated a desire for routes that may be unethical. This process which is named transplant tourism is the term used to describe traveling to another country to purchase an organ for transplant. Liver transplant tourism has been associated with post-transplant complications and higher mortality compared to a domestic liver transplant. Improper pre-and post-transplant infectious screening, inadequate opportunistic infection prophylaxis, and loss to follow-up were noted in patients who travel abroad for a liver transplant. It is crucial to understand the risk of transplant tourism to prevent morbidity and mortality.

Keywords: Commercial transplant, Liver transplant, Organ tourism, Transplant tourism

Core Tip: Liver transplant tourism can be associated with higher post-operative infections, biliary complications, and mortality compared to a domestic liver transplant. Pre-transplant education about the risk of liver transplant tourism and post-transplant management is essential to improve the patients' outcomes.