Living Paid Organ Transplantation Results in Unacceptably High Recipient Morbidity and Mortality

Inston, Nicholas; Gill, D. G.; Alhakim, Anas; Ready, Andrew

doi:10.1016/j.transproceed.2004.12.178

Cited by 48 publications

(15 citation statements)

References 3 publications

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“…In this case the type of vascular damage with the consequent infarction of the graft lower pole and complete pyelo-ureteral necrosis remains obscure since no adequate information regarding both donor and recipient was provided from the transplanting center [2]. Despite the successful surgical pyelovesical anastomosis and good recovery of the patient and the kidney, long term prognosis remains poor in line with our previous report [3].…”

Section: Discussionsupporting

confidence: 49%

Pyelo-ureteral necrosis after renal transplantation

Spasovski¹,

Masin-Spasovska²,

Stavridis³

et al. 2008

Int Urol Nephrol

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Because of the limited chance of receiving a kidney transplant (for several well-known reasons), a lot of desperate dialysis patients procure an unrelated donor kidney transplant against all medical advice. This type of renal paid transplantation is associated with many surgical complications and invasive opportunistic infections that increase the morbidity and mortality in this group of transplant recipients. In this report, we describe a case of a 22-year-old girl with a segmental infarction of the graft lower pole and a complete pyelo-ureteral necrosis as a consequence of some vascular damage, complicated by a pathohistological finding of an invasive candidiasis. Despite the successful surgical pyelovesical anastomosis and the good recovery of the patient and the kidney, long-term prognosis remains poor. The lack of information from the transplanting center regarding both donor and recipient and the associated, unacceptable risks on the graft and patient survival in unrelated, paid transplant recipients reinforce the standpoint that this practice should be abandoned.

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Section: Discussionsupporting

confidence: 49%

Pyelo-ureteral necrosis after renal transplantation

Spasovski¹,

Masin-Spasovska²,

Stavridis³

et al. 2008

Int Urol Nephrol

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“…Outcomes of recipients from the UK: Inston et al [14] in 2005 reported a study of 23 patients from the UK, he found that 8 patients (35%) died shortly after their return and 5 more (21%) lost their kidneys. The overall rate of successful transplants from this group of patients was only 44% (overall graft loss was 56%) in the short term.…”

Section: Resultsmentioning

confidence: 99%

“…All patients received cyclosporine, prednisone and azathioprine or MMF. Inston et al [14] in a study of 23 patients from the UK found an overall success rate of only 44%. In an earlier study, Higgins et al [15] found that the survival rate was 68 and 92% in commercial and non-commercial renal transplant recipients, respectively.…”

Section: Critique Of Literaturementioning

confidence: 99%

Commercialization of Kidney Transplants: A Systematic Review of Outcomes in Recipients and Donors

Sajjad

Baines²,

Patel³

et al. 2008

Am J Nephrol

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In this study we systematically reviewed outcomes in recipients and donors of commercial kidney transplants. Inherent in a study of this nature is the possibility of center and country bias, in particular there are no publications from China and South America. Publications also tended to report poor outcomes which may reflect bias on the part of the authors or to highlight the ethical issues in this area. We were unable to perform a meta-analysis due to variability in studies making it impossible to synthesize the data other than descriptive. Furthermore, these studies were not large or well conducted. We found that patient and graft survival was generally inferior to the data obtained from the UNOS (United Network for Organ Sharing). Some studies did achieve good outcomes, however, due to lack of details, it was not possible to infer if the donor hospital, surgical technique or immunosuppressive regimen was a factor. There was a higher incidence of unconventional and life-threatening infections such as malaria, invasive fungal infections, pneumonia, HIV and hepatitis. There was also a markedly increased incidence of postoperative surgical interventions in recipients. We suggest the establishment of a database for both recipients and donors to identify unique surgical, medical, infectious and immunosuppressive protocols for the recipients and donors in these hospitals. This could lead to better liaison between the recipient and donor hospitals so that modern surgical and medical practices can be implemented. There should also be improved emotional and psychological support to both the recipient and the donor. However, these steps could be seen as condoning the reprehensible practice of commercialization of human body parts.

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“…When they return to their home transplant centre they often have inadequate records of what was done to them, little information about the organs they received or no records at all. All of these problems compromise their health, their lives and their transplanted organs (Ivanovski et al, 1997;Chugh and Jha, 2000;Sever et al, 2001;Higgins et al, 2003;Inston et al, 2005;Kennedy et al, 2005;Canales et al, 2006;Prasad et al, 2006;Bramstedt and Xu, 2007).…”

Section: Some Facts About Transplant Tourism In the Usmentioning

confidence: 99%