A Regulated System of Incentives for Kidney Donation-Time for a Trial!

A Survey Study to Examine Willingness to Travel for Transplantation and Consider Commercial Transplantation Among a Multi-Ethnic Cohort of Canadians

Introduction

Travel for transplantation is the movement of organs, donors, recipients, or transplant professionals across jurisdictional borders for transplantation purposes and is considered transplant tourism if transplant commercialism is involved. Little is known about the willingness of patients at risk for transplant tourism to engage in this practice.

Methods

A cross-sectional survey of patients with end-stage renal disease was conducted in Canada to determine interest in travel for transplantation and transplant tourism, characterize patients according to their willingness to consider transplant tourism, and identify factors to deter willingness to consider transplant tourism. Surveys were conducted face-to-face and in multiple languages.

Results

Among the 708 patients surveyed, 418 (59%) reported a willingness to travel outside of Canada for transplantation, with 24% reporting a strong willingness. One hundred sixty-one (23%) reported a willingness to travel and purchase a kidney overseas. On multivariate analysis, male sex, younger age, and Pacific Islander ethnicity were associated with higher odds of willingness to travel for transplant, whereas male sex, annual income greater than $100,000, and Asian and Middle Eastern ethnicity were associated with higher odds of willing to travel to purchase a kidney. Willingness reduced when respondents were informed of medical risks and legal implications related to travel for transplantation. Financial and ethical considerations were less effective at reducing willingness to travel for transplantation.

Conclusion

There was a high level of interest in travel for transplantation and transplant tourism. Legal consequences and education on medical risks of transplant tourism may be effective deterrent strategies.