Review
Copyright ©2012 Baishideng. All rights reserved.
World J Transplant. Feb 24, 2012; 2(1): 9-18
Published online Feb 24, 2012. doi: 10.5500/wjt.v2.i1.9
Key issues in transplant tourism
Jacob A Akoh
Jacob A Akoh, South West Transplant Centre, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, United Kingdom
Author contributions: Akoh JA solely contributed to this paper.
Correspondence to: Jacob A Akoh, FRCSEd, FRCS (Gen), Consultant General and Transplant Surgeon, South West Transplant Centre, Plymouth Hospitals NHS Trust, Level 04, Derriford Hospital, Plymouth PL6 8DH, United Kingdom. jacob.akoh@nhs.net
Telephone: +44-1752-439798 Fax: +44-1752-774651
Received: July 14, 2011
Revised: December 18, 2011
Accepted: February 23, 2012
Published online: February 24, 2012
Abstract

Access to organ transplantation depends on national circumstances, and is partly determined by the cost of health care, availability of transplant services, the level of technical capacity and the availability of organs. Commercial transplantation is estimated to account for 5%-10% (3500-7000) of kidney transplants performed annually throughout the world. This review is to determine the state and outcome of renal transplantation associated with transplant tourism (TT) and the key challenges with such transplantation. The stakeholders of commercial transplantation include: patients on the waiting lists in developed countries or not on any list in developing countries; dialysis funding bodies; middlemen, hosting transplant centres; organ-exporting countries; and organ vendors. TT and commercial kidney transplants are associated with a high incidence of surgical complications, acute rejection and invasive infection which cause major morbidity and mortality. There are ethical and medical concerns regarding the management of recipients of organs from vendors. The growing demand for transplantation, the perceived failure of altruistic donation in providing enough organs has led to calls for a legalised market in organ procurement or regulated trial in incentives for donation. Developing transplant services worldwide has many benefits - improving results of transplantation as they would be performed legally, increasing the donor pool and making TT unnecessary. Meanwhile there is a need to re-examine intrinsic attitudes to TT bearing in mind the cultural and economic realities of globalisation. Perhaps the World Health Organization in conjunction with The Transplantation Society would set up a working party of stakeholders to study this matter in greater detail and make recommendations.

Keywords: Living unrelated donor; Organ trafficking; Transplant commercialism; Infection; Graft survival; Patient survival; Complication