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Parsons RF, John P. Greater Awareness and Improved Governance of Transplant Tourism Among Desperate Patients Is Needed. Kidney Int Rep 2023; 8:693-695. [PMID: 37069972 PMCID: PMC10105219 DOI: 10.1016/j.ekir.2023.02.1083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Affiliation(s)
- Ronald F. Parsons
- Department of Surgery, Division of Transplantation, Emory University School of Medicine, Atlanta, Georgia, USA
- Correspondence: Ronald F. Parsons, Department of Surgery, Emory University School of Medicine, 101 Woodruff Circle, 5105WMB, Atlanta, Georgia 30322 USA.
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Altheaby A, Owaidah K, Alotaibi A, Salem R, Algain R, Alotaibi A, Alnasrullah A, Shaheen MF, Tawhari M, Abdulgadir M. Graft and Patient Outcomes of Kidney Transplant Tourism: A Single-Center Experience. Avicenna J Med 2022; 12:120-126. [PMID: 36092382 PMCID: PMC9458345 DOI: 10.1055/s-0042-1750715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background
The supply-demand mismatch between organ donor and patient waiting for transplant has led to the growth of transplant tourism. This type of transplant is considered unethical and illegal, as it is usually performed in poor environments and carries a higher risk of infectious, vascular, and immunological complications.
Methods
In this single-centered retrospective cohort study, we compared patients who underwent transplant tourism to patients who were transplanted locally and followed up in our hospital from January 2015 to December 2018.
Result
A total of 254 local transplants and 60 patients from the transplant tourism group were included. Transplant tourism recipients were younger otherwise both groups were similar in gender, body mass index, diabetes, and hypertension. Recipients in the transplant tourism group had a significantly higher rate of delayed graft function (18.3% vs. 6.3%,
p
0.005), acute rejection (40% vs. 7.9%,
p
< 0.001), and higher posttransplant infection in general. With more urological complications and higher graft failure at 3-years' follow-up (11.7% vs. 0.8%,
p
< 0.001).
Conclusion
Transplant tourism is associated with a higher risk of infection and poor graft outcomes. Extra efforts are required to cut down transplant tourism by educating patients about its clinical risk and ethical considerations. In addition, measures to increase the number of deceased donor pool to provide a better alternative options for patients are essential.
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Affiliation(s)
- Abdulrahman Altheaby
- Department of Organ Transplant Center and Hepatobiliary Sciences, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Kenana Owaidah
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Aljowharah Alotaibi
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Rahaf Salem
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Rihaf Algain
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Areij Alotaibi
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ahmad Alnasrullah
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed F. Shaheen
- Department of Organ Transplant Center and Hepatobiliary Sciences, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohammed Tawhari
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Medicine, King Saud bin Abdulaziz University for Health Science, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Mohamad Abdulgadir
- Department of Organ Transplant Center and Hepatobiliary Sciences, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Pérez-Blanco A, López-Fraga M, Forsythe J, Pires Silva AM, Cardillo M, Novotná P, Tullius SG, Cozzi E, Ashkenazi T, Delmonico FL, Domínguez-Gil B, Brix-Zuleger M, Colenbie L, Tsoneva D, Bušić M, Nicolaos M, Adamec M, Makisalo H, Arrabal S, Pérel Y, Cantrelle C, Legeai C, Rahmel A, Menoudakou G, Sándor M, Lavee J, Bellis L, Ciaccio P, Gembutiene V, Abela C, Codrenau I, Kaminski A, Kratka M, Avsec D, Alvarez M, Carmona M, Beyeler F, Thaqi A, Haase B, Ünsal İ, Gardiner D, McGowan O, Branger P, Ericzon BG, Birrell L. Access of non-residents to transplantation of deceased donor organs: practices and strategies in the European setting. Transpl Int 2021; 34:2112-2121. [PMID: 34553794 DOI: 10.1111/tri.14113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Abstract
The access of non-resident patients to the deceased donor waiting list (DDWL) poses different challenges. The European Committee on Organ Transplantation of the Council of Europe (CD-P-TO) has studied this phenomenon in the European setting. A questionnaire was circulated among the Council of Europe member states to inquire about the criteria applied for non-residents to access their DDWL. Information was compiled from 28 countries. Less than 1% of recipients of deceased donor organs were non-residents. Two countries never allow non-residents to access the DDWL, four allow access without restrictions and 22 only under specific conditions. Of those, most give access to non-resident patients already in their jurisdictions who are in a situation of vulnerability (urgent life-threatening conditions). In addition, patients may be given access: (i) after assessment by a specific committee (four countries); (ii) within the framework of official cooperation agreements (15 countries); and (iii) after patients have officially lived in the country for a minimum length of time (eight countries). The ethical and legal implications of these policies are discussed. Countries should collect accurate information about residency status of waitlisted patients. Transparent criteria for the access of non-residents to DDWL should be clearly defined at national level.
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Affiliation(s)
| | - Marta López-Fraga
- European Directorate for the Quality of Medicines & HealthCare (EDQM), Council of Europe, Strasbourg, France
| | | | - Ana M Pires Silva
- Instituto Português de Sangue e da Transplantação (IPST), Lisbon, Portugal
| | - Massimo Cardillo
- Centro Nazionale Trapianti-Istituto Superiore di Sanità (CNT-ISS), Rome, Italy
| | - Petra Novotná
- Koordinační středisko transplantací (KST), Prague, Czech Republic
| | - Stefan G Tullius
- Division of Transplant Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
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4
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Ayala-García MA, Ríos Zambudio A, Martínez-Martínez OI, González Yebra B, Cancino Marentes ME, Rivera Barragán V, Pantoja Hernández MÁ, Cargill Foster NR, Soto Saldaña L, Reyes Sánchez J, Vázquez Guerrero MÁ, Castillo Cardiel JA, Flores-Vargas G. Multicentric Study to Evaluate Mexican Medical Students' Knowledge of Transplants and Organ Donation. Transplant Proc 2020; 52:1030-1035. [PMID: 32241634 DOI: 10.1016/j.transproceed.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 01/22/2020] [Accepted: 02/05/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Transplants and organ donation are greatly aided by future medical professionals having adequate knowledge of this topic. This study aimed to elucidate the level of Mexican medical students' knowledge in the field of transplants and organ donation. MATERIALS AND METHODS The evaluation instrument was designed and validated. The design used simple sampling with replacement, selecting a random sample of 5 universities from among the institutional members of the Mexican Association of Departments and Schools of Medicine (Asociación Mexicana de Facultades y Escuelas de Medicina [AMFEM]). The sample was composed of 3214 medical students. Measures of central tendency were determined, and the mean scores obtained across the different universities were compared using a Kruskal-Wallis test. The odds ratio was calculated for the students whose school or department included instruction on transplants and donation within their curriculum. Kendall correlation was used for the students' academic grade level and score. All analyses considered a threshold of P < .05. RESULTS A questionnaire was administered to a sample of 2563 students to evaluate their knowledge of transplants and organ donation. The average score was 4.02 on a scale of 0 to 10 (standard deviation 0.03), with a 95% confidence interval (3.96-4.08). Students whose school or department taught the subject of transplants and donations within their curriculum obtained an odds ratio of 1.44 (P = .0000822). CONCLUSIONS The findings of this study suggest that medical students in Mexico do not have sufficient knowledge of transplants and organ donation.
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Affiliation(s)
- Marco Antonio Ayala-García
- Surgery Department, Hospital General Regional, Instituto Mexicano del Seguro Social, Delegación Guanajuato, León, Guanajuato, México; Research Commettee, Medical School Universidad Quetzalcóatl en Irapuato, Irapuato, Guanajuato, México; Colaborative Proyect Internacional Donor, España.
| | - Antonio Ríos Zambudio
- Colaborative Proyect Internacional Donor, España; Trasplants Unit, Hospital Universitario Virgen de la Arrixaca, Murcia, España; Surgery Department, Universidad de Murcia, España
| | | | - Beatriz González Yebra
- Medical and Nutricional Department, Universidad de Guanajuato Campus León, León, Guanajuato, México; Research Unit, Hospital Regional de Alta Especialidad del Bajío, León, Guanajuato, México
| | - Martha Edith Cancino Marentes
- Public Health Master Degree Coordination (PNPC CONACyT), Medical Academy Unit Universidad Autónoma de Nayarit, Tepic, Nayarit, México
| | - Virgilio Rivera Barragán
- Medicine Department, Universidad Autónoma de Aguascalientes, Aguascalientes, Aguascalientes, México
| | | | - Nelly Ruth Cargill Foster
- Medicine Faculty, Health Science Academy Division, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, México
| | - Lisandra Soto Saldaña
- Research Commettee, Medical School Universidad Quetzalcóatl en Irapuato, Irapuato, Guanajuato, México
| | - Jorge Reyes Sánchez
- Odontology Faculty, Universidad Quetzalcóatl en Irapuato, Irapuato, Guanajuato, México
| | | | | | - Gilberto Flores-Vargas
- Master in Probability and Statistics, Centro de Investigaciones en Matemáticas, A.C, Guanajuato, Guanajuato, México
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Hindi Z, Congly S, Tang E, Skaro A, Brahmania M. Liver Transplant Tourism. Liver Transpl 2020; 26:276-282. [PMID: 31765044 DOI: 10.1002/lt.25692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 11/08/2019] [Indexed: 12/14/2022]
Abstract
Liver transplant tourism is travel for transplantation involving organ trafficking and/or transplant commercialism. Various medical, financial, and organizational factors play a role in transplant care including waiting lists, Model for End-Stage Liver Disease scores, and financial aid. We outline the international experiences with transplant tourism (TT) and its effect on their medical communities and patients. For clinicians providing care to patients involved in TT, we also discuss pretransplant counseling and posttransplant care.
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Affiliation(s)
- Zaid Hindi
- Department of Medicine, Division of Gastroenterology, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Stephen Congly
- Department of Medicine, Division of Gastroenterology, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
| | - Ephraim Tang
- Department of Surgery, Division of General Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Anton Skaro
- Department of Surgery, Division of General Surgery, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Mayur Brahmania
- Department of Medicine, Division of Gastroenterology, London Health Sciences Centre, Western University, London, Ontario, Canada
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Abstract
PURPOSE OF REVIEW To outline the impact of transplant tourism on the type and severity of post-transplant infections that may be seem in returning transplant tourists. This review outlines infections that might be expected and provides recommendations on screening tests that may assist in the diagnosis and management of such patients. RECENT FINDINGS Transplant tourists may develop unusual or resistant infections that pose a public health risk in their home country. The practice of transplant tourism is associated with a significantly increased risk of surgical and infectious complications after transplant. Returning transplant tourists require a thorough evaluation for active and latent infections. Transplant centers must be vigilant for new and emerging pathogens in this population.
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Affiliation(s)
- Michele I Morris
- Division of Infectious Diseases, University of Miami Miller School of Medicine, 1120 NW 14th St., Suite 842 (R-21), Miami, FL, 33136, USA.
| | - Elmi Muller
- Division of General Surgery, Department of Surgery, Groote Schuur Hospital, University of Cape Town, Observatory, Cape Town, 7925, South Africa
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Buchan CA, Kotton CN. Travel medicine, transplant tourism, and the solid organ transplant recipient-Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13529. [PMID: 30859623 DOI: 10.1111/ctr.13529] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 02/26/2019] [Indexed: 12/13/2022]
Abstract
These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review recommendations for prevention and management of travel-related infection in solid organ transplant (SOT) recipients as well as risks associated with transplant tourism. Counseling regarding travel post-transplant should be included during the pre-transplant evaluation, and all SOT recipients should be seen by a travel medicine specialist prior to traveling to destinations with higher rates of infection. Patients should be advised on vaccine-preventable illnesses as well as any need for prophylaxis (ie, malaria) based on their individual travel itineraries. Information with regards to specific recommendations for vaccines and prophylactic medications, along with drug-drug interactions, is summarized. Counseling should be provided for modifiable risks and exposures (ie, food and water safety, and insect bite prevention) as well as non-infectious travel topics. These guidelines also briefly address risks associated with transplant tourism and specific infections to consider if patients seek care for transplants done in foreign countries.
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Affiliation(s)
- C Arianne Buchan
- Division of Infectious Diseases, The Ottawa Hospital, Ottawa, Ontario, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.,The University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Camille Nelson Kotton
- Transplant Infectious Disease and Compromised Host Program, Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts.,Travelers' Advice and Immunization Center, Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
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8
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AlBugami MM, AlOtaibe FE, Alabadi AM, Hamawi K, Bel'eed-Akkari K. Transplant tourism following the declaration of Istanbul: Poor outcomes and nephrologist dilemma. Nephrology (Carlton) 2018; 23:1139-1144. [DOI: 10.1111/nep.13181] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2017] [Indexed: 01/16/2023]
Affiliation(s)
- Meteb M AlBugami
- Multi-Organ Transplant Center; King Fahad Specialist Hospital; Dammam Saudi Arabia
- Department of Internal Medicine, College of Medicine; University of Dammam; Dammam Saudi Arabia
| | - Fahad E AlOtaibe
- Multi-Organ Transplant Center; King Fahad Specialist Hospital; Dammam Saudi Arabia
- Department of Internal Medicine, College of Medicine; University of Dammam; Dammam Saudi Arabia
| | - Abdulnaser M Alabadi
- Multi-Organ Transplant Center; King Fahad Specialist Hospital; Dammam Saudi Arabia
| | - Khaled Hamawi
- Multi-Organ Transplant Center; King Fahad Specialist Hospital; Dammam Saudi Arabia
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9
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Sweileh WM. Research trends on human trafficking: a bibliometric analysis using Scopus database. Global Health 2018; 14:106. [PMID: 30409223 PMCID: PMC6225706 DOI: 10.1186/s12992-018-0427-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 10/24/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Human trafficking is a crime against humanity. It is also a serious threat to global health and security. Globalization has made human trafficking an easier task for the criminal organizations. No data are available on the volume, research trends, and key players in this field. Therefore, the aim of this study was to assess the research activity and research trends on human trafficking. METHODS A bibliometric method was adopted. Literature published in academic journals indexed in Scopus database was retrieved. The study period was set from 2000 to 2017. RESULTS Two thousand forty-four documents were retrieved. The average number of authors per document was 1.9. Over one third (n = 771; 37.7%) of the retrieved documents were about sex trafficking, 616 (30.1%) were about labor trafficking/forced labor, 199 (9.7%) were about child trafficking, and 138 (6.8%) were about organ trafficking. One third (n = 707; 34.6%) of the documents were in health-related fields while 1526 (74.7%) were in social sciences and humanities. The USA ranked first (n = 735; 36.0%) regarding the number of published documents. Geographic distribution of the retrieved document showed that world regions with a high prevalence of human trafficking had the least research contribution. International research collaboration has a limited contribution to the retrieved literature. The Harvard University (USA) was the most active institution (n = 39; 1.9%). International Migration (n = 35; 1.7%) was the most active journal in publishing documents on HT. Documents published in Transplantation journal received the highest number of citations per document (25.5) and two of the most cited documents were about organ trafficking. CONCLUSION There was an under-representation of health-related literature on human trafficking. Literature on sex trafficking dominated the field of human trafficking. Research networks and research collaboration between the source and destination countries is important. Future research plans need to focus on health issues and on exploited/trafficked laborers.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Al Riyami MS, Al Saidi S, Al Ghaithi B, Al Maskari A, Lala S, Mohsin N, Hirshikesan L, Al Kalbani N. Pediatric Renal Transplantation in Oman: A Single-center Experience. Oman Med J 2018; 33:7-14. [PMID: 29467993 DOI: 10.5001/omj.2018.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objectives This study sought to report 22 years experience in pediatric kidney transplantation in Oman. Methods Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection) graft and patient survival, and duration of follow-up. Results During the study period transplantation from 27 living related donors (LRDs), 42 living unrelated donors (LURDs), also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications (42.8%) compared to the LRDs group (17.8%). Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group. Conclusions Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival.
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Affiliation(s)
- Mohamed S Al Riyami
- Pediatric Nephrology Unit, Department of Child Health, Royal Hospital, Muscat, Oman
| | - Sulaiman Al Saidi
- Pediatric Nephrology Unit, Department of Child Health, Royal Hospital, Muscat, Oman
| | - Badria Al Ghaithi
- Pediatric Nephrology Unit, Department of Child Health, Royal Hospital, Muscat, Oman
| | - Anisa Al Maskari
- Pediatric Nephrology Unit, Department of Child Health, Royal Hospital, Muscat, Oman
| | - Sadiq Lala
- Urology Unit, Department of Surgery, Royal Hospital, Muscat, Oman
| | - Nabil Mohsin
- Department of Medicine, College of Medicine, Sultan Qaboos University, Muscat, Oman
| | - Lekha Hirshikesan
- Department of Nephrology Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India
| | - Naifain Al Kalbani
- Pediatric Nephrology Unit, Department of Child Health, Royal Hospital, Muscat, Oman
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Al Rahbi F, Al Salmi I. Commercial Kidney Transplantation: Attitude, Knowledge, Perception, and Experience of Recipients. Kidney Int Rep 2017; 2:626-633. [PMID: 29142981 PMCID: PMC5678620 DOI: 10.1016/j.ekir.2017.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 02/09/2017] [Accepted: 02/13/2017] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Kidney transplantation is the gold standard for patients with end-stage kidney disease. In view of shortages of available organs, long wait times for possible transplantation, and strict regulation, many patients opt for commercial transplantation. This study elicits the reasons and motivations for patients with end-stage kidney disease to elect for commercial transplant. METHODS A questionnaire-based evaluation was conducted during the period from July 2015 until late December 2015. It consisted of 29 multiple choice questions and was distributed to all patients who underwent commercial kidney transplantation. RESULTS One hundred and fifty patients were approached to participate and 106 agreed. Of the participants, 60% were male with an average age of 41.5 (SD 14.8) years and ranged from 18 to 83 years. The majority (82%) of our participants were educated ranging from primary to college level. The major reason (71%) for these participants to obtain commercial transplants was stated as the unavailability of a live related donor. Thirteen percent stated that they objected to getting a kidney donated from a family member, and 9% stated that they were worried about taking a kidney from a family member. Finally, 3% of participants stated that they needed prompt transplant and could not wait for a long time for transplant investigations and the workup associated with this program. DISCUSSION The study showed that the most common underlying cause for seeking commercial transplantation is the unavailability of a national transplant program, particularly transplantation from deceased sources. All western ethical arguments turn out to become of vital importance in developing countries, because transplantation is the cheapest renal replacement therapy. However, it must be emphasized that commercial transplants should not be an alternative to building a national transplant initiative. The national diseased program must be a priority with full financial and administrative support. All government agencies including religious affairs must work together to support the program and to provide the citizens with a good transplantation service and ameliorate the impact of commercial transplantation.
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Affiliation(s)
- Fatma Al Rahbi
- Renal Medicine Department, The Royal Hospital, Muscat, Oman
| | - Issa Al Salmi
- Renal Medicine Department, The Royal Hospital, Muscat, Oman
- Correspondence: Issa Al Salmi, The Royal Hospital, PO Box 1331, code 111, Muscat, Oman.The Royal HospitalPO Box 1331, code 111MuscatOman
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