Sharing Organs with Foreign Nationals

Abstract

Organs for transplantation are an absolute scarcity throughout the world, and many countries do not offer transplantation. Developed countries with transplant programs receive requests to list foreign nationals for transplantation. Any national standard deserves justification by a thorough exploration of the issues. In this article, the issues regarding organ transplantation for foreign nationals in Canada are explored. Currently Canada has no policy on listing foreign nationals for transplantation. Three topics are reviewed: (1) arguments for and against the transplantation of organs from deceased donors to foreign nationals, (2) relevant legislation and position statements, and (3) relevant practices in other countries. Finally, practical policy options are suggested. This article's analysis of the issues will provide guidance for health care professionals and policy makers in Canada and developed countries exploring listing foreign nationals for transplantation.

Organ Transplantation for Foreign Nationals in Canada: A Survey of Transplant Professionals

“…guided the development of the survey questions. [2][3][4] The survey began with six fictitious clinical scenarios in which an FN needed a transplant. For each scenario, respondents had to choose from the following five options: (1) to list the patient (with or without urgent status, depending on the case); (2) to refuse to list the patient; (3) to offer the transplant only when the patient had a living kidney donor (in cases of kidney and liver transplantation); (4) to list the patient, but prioritize nationals over FNs; (5) to offer or not to offer a left ventricular assist device, in the case of a heart transplant.…”

“…1 Various arguments are used to support or oppose organ transplantation for FNs, such as justice, reciprocity, and physicians' duties toward vulnerable populations. [2][3][4][5][6] It is beyond the scope of this article to review these arguments in detail.…”

Fluchtwege von schwerkranken Kindern und Jugendlichen aus den ehemaligen Ostblockländern nach Deutschland zur Behandlung des Nierenversagens

“…Die chronische Dialysebehandlung von Kindern war in den Herkunftsländern auf Grund von Komplikationen und/oder Finanzierungsproblemen sehr schwierig geworden und die Familien erwarteten in Deutschland Hilfe und eine rasche Nierentransplantation. Die Hälfte der Hilfesuchenden ging davon aus, dass die Nierentransplantation in Deutschland unmittelbar zur Verfügung steht, während diese Therapieoption in ihren Heimatländern meist nicht verfügbar ist [2,5].…”

“…Während medizinische und ökonomische Gründe für die Nierentransplantation bei Asylsuchenden sprechen, stellt der Mangel an Spenderorganen ein großes Problem dar [1,2]. Auch weil Kinder und Jugendliche nach Richtlinien zur Organtransplantation bis zur Vollendung des 16.…”