J Korean Med Sci.  2011 Jan;26(1):17-21. 10.3346/jkms.2011.26.1.17.

Trend and Outcome of Korean Patients Receiving Overseas Solid Organ Transplantation between 1999 and 2005

• Kwon CH
• Lee SK
• Ha J

• KMID: 1777970
• DOI: http://doi.org/10.3346/jkms.2011.26.1.17

Abstract

The disparity between patients awaiting transplantation and available organs forced many patients to go overseas to receive a transplant. Few data concerning overseas transplantation in Korea are available and the Korea Society for Transplantation conducted a survey to evaluate the trend and outcome of overseas transplantation. The survey, conducted on June 2006, included 25 hospitals nationwide that followed up patients after receiving kidney transplant (KT) or liver transplant (LT) overseas. The number of KT increased from 6 in 2001 to 206 in 2005 and for LT from 1 to 261. The information about overseas transplant came mostly from other patients (57%). The mean cost for KT was dollar 21,000 and for LT dollar 47,000. Patients were admitted for 18.5 days for KT and 43.4 days for LT. Graft and patient survival was 96.8% and 96.5% for KT (median follow up 23.1 months). Complication occurred in 42.5% including surgical complication (5.3%), acute rejection (9.7%) and infection (21.5%). Patient survival for LT was 91.8% (median follow up 21.2 months). Complication occurred in 44.7% including 19.4% biliary complication. Overseas KT and LT increased rapidly from 2001 to 2005. Survival of patients and grafts was comparable to domestic organ transplantation, but had a high complication rate.

Keyword

Transplant Tourism; Medical Tourism; Commercial Organ Transplantation; Kidney Transplantation; Liver Transplantation; Outcome

MeSH Terms

Graft Rejection/complications
Graft Survival
Humans
Kidney Transplantation/adverse effects/economics/trends
Liver Transplantation/adverse effects/economics/trends
Organ Transplantation/adverse effects/economics/*trends
Postoperative Complications/epidemiology
Questionnaires
Republic of Korea

Figure

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  Fig. 1 Annual number of kidney transplantation reported in Korea. The proportion of domestic deceased donor, domestic living donor and overseas kidney transplantation is shown. The proportion of domestic deceased donor kidney transplantation has not changed over time (from 17.0% to 17.8%) while overseas transplantation has increased abruptly since 2002. Deceased (□), living (■), and overseas (■) kidney transplantation.

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  Fig. 2 Annual number of liver transplantation reported in Korea. Overseas domestic deceased donor, domestic living donor and overseas liver transplantation is shown. Overseas transplantation has increased exponentially since 2002. Deceased (□), living (■), and overseas (■) liver transplantation.

Reference

1. International Summit on Transplant Tourism and Organ Trafficking. The declaration of Istanbul on organ trafficking and transplant tourism. Clin J Am Soc Nephrol. 2008. 3:1227–1231.

2. Budiani-Saberi DA, Delmonico FL. Organ trafficking and transplant tourism: a commentary on the global realities. Am J Transplant. 2008. 8:925–929.

3. Freeman RB. "Transplant tourism" in the United States? Transplantation. 2007. 84:1559–1560.

4. Kennedy SE, Shen Y, Charlesworth JA, Mackie JD, Mahony JD, Kelly JJ, Pussell BA. Outcome of overseas commercial kidney transplantation: an Australian perspective. Med J Aust. 2005. 182:224–227.

5. Schold JD, Meier-Kriesche HU, Duncan RP, Reed AI. Deceased donor kidney and liver transplantation to nonresident aliens in the United States. Transplantation. 2007. 84:1548–1556.

6. Shibolet O, Rowe M, Safadi R, Levy I, Zamir G, Eid A, Donchin Y, Ilan Y, Shouval D. Air transportation of patients with end-stage liver disease to distant liver transplantation centers. Liver Transpl. 2005. 11:650–655.

7. Merion RM, Barnes AD, Lin M, Ashby VB, McBride V, Ortiz-Rios E, Welch JC, Levine GN, Port FK, Burdick J. Transplants in foreign countries among patients removed from the US transplant waiting list. Am J Transplant. 2008. 8:988–996.

8. Baek BS, Choi DL, Han YS, Kim MK. Clinical features of patients who received liver transplantation in China. J Korean Soc Transplant. 2006. 20:248–252.

9. Kang WN, Ju MK, Chang HK, Ahn HJ, Jeun KO, Kim HJ, Kim MS, Kim SI, Kim YS. Surgical Complications are major problems concerning overseas kidney transplantation in comparison study with domestic deceased donor kidney transplantation. J Korean Soc Transplant. 2007. 21:119–122.

10. 2008 Annual Data Report. Korean Network for Organ Sharing (KONOS). accessed on Aug 20 2009. Available at http://konos.go.kr.

11. Huang J. Ethical and legislative perspectives on liver transplantation in the People's Republic of China. Liver Transpl. 2007. 13:193–196.

12. Pact to block harvesting of inmate organs. South China Morning Post. 2007. 10. 07. 1.

13. Chinese Medical Association Reaches Agreement With World Medical Association Against Transplantation Of Prisioners's (sic) Organs. Medical News Today. 2007. 10. 07.

14. Sugo H, Balderson GA, Crawford DH, Fawcett J, Lynch SV, Strong RW, Futagawa S. Overseas liver transplantation for hepatitis C in Japanese patients: a comparison with patients from Australia/New Zealand. Transplant Proc. 2002. 34:3323–3324.

15. Canales MT, Kasiske BL, Rosenberg ME. Transplant tourism: Outcomes of United States residents who undergo kidney transplantation overseas. Transplantation. 2006. 82:1658–1661.

16. The Living Non-Related Renal Transplant Study Group. Commercially motivated renal transplantation: results in 540 patients transplanted in India. Clin Transplant. 1997. 11:536–544.

17. Alghamdi SA, Nabi ZG, Alkhafaji DM, Askandrani SA, Abdelsalam MS, Shukri MM, Eldali AM, Adra CN, Alkurbi LA, Albaqumi MN. Transplant tourism outcome: a single center experience. Transplantation. 2010. 90:184–188.

18. Ivanovski N, Masin J, Rambabova-Busljetic I, Pusevski V, Dohcev S, Ivanovski O, Popov Z. The outcome of commercial kidney transplant tourism in Pakistan. Clin Transplant. 2010. 07. 06. [Epub ahead of print].

19. Sharma S, Gurakar A, Jabbour N. Biliary strictures following liver transplantation: past, present and preventive strategies. Liver Transpl. 2008. 14:759–769.

20. Reich DJ, Hong JC. Current status of donation after cardiac death liver transplantation. Curr Opin Organ Transplant. 2010. 15:316–321.

21. World Health Organization. WHO guiding principles on human cell, tissue and organ transplantation. Transplantation. 2010. 90:229–233.