Going Abroad for Kidney Transplant is Not Worth the Trip

[okarol]

Going Abroad for Kidney Transplant is Not Worth the Trip

June Chen, MD
Oct. 24, 2008

Hundreds of Americans go abroad each year for kidney transplants in order to avoid the long waiting lists in the United States. People who leave the country for these transplants experience more severe post-operative complications, more infections, and a higher risk for acute organ rejection, according to a new study published in the upcoming November issue of the Clinical Journal of the American Society of Nephrology.

Researchers from the University of California, Los Angeles (UCLA) and their colleagues compared the health conditions of 66 patients who had undergone kidney transplant at UCLA with the conditions of 33 people who had gone abroad for their transplants. A year after transplant, kidney rejection occurred in 30% of those who had gone out of the country and 12% who had undergone transplant at UCLA. 'Transplant tourists' were also three times more likely to be hospitalized for infection after their transplant operation.

In the United States, the average wait for a kidney transplant is approximately five years. Buying or selling human tissue is illegal in the United States, but for many who are awaiting transplant, it is tempting to go abroad and buy organs. However, in other countries, these patients run the risk of poor preventive care for infections and of not knowing where the organs come from or what the health status of the donor was. Although people with chronic kidney disease may feel desperate to free themselves from dialysis, the relative risks and benefits of becoming a transplant tourist should be carefully considered.

Source
News release, American Society of Nephrology.

http://www.healthandage.com/public/news/16803/Going-Abroad-for-Kidney-Transplant-is-Not-Worth-the-Trip.html

[Hippy]

http://www.doh.gov.ph/node/1986/print  DOH Clarifies Exemption of 8 Foreigners for Kidney Transplant. I had read elsewhere that in the Philippines they will allow the donors to be tested at any lab of our choosing and to have American Doctors check everything about the donor.

   I suppose that Dr. Chen in warning us not to go overseas was talking about her homeland of China, where they were executing prisoners for the organs. Dr June Chen talks about Transplant Tourists, is she a Transplant Tourist from China ?

[monrein]

http://www.doh.gov.ph/node/1986/print  DOH Clarifies Exemption of 8 Foreigners for Kidney Transplant. I had read elsewhere that in the Philippines they will allow the donors to be tested at any lab of our choosing and to have American Doctors check everything about the donor.

   I suppose that Dr. Chen in warning us not to go overseas was talking about her homeland of China, where they were executing prisoners for the organs. Dr June Chen talks about Transplant Tourists, is she a Transplant Tourist from China ?

I'm confused.  Oh no Monrein, not again, you confused.  Anyhow, what is there here to suggest that Dr. Chen is anything other than a doctor with a Chinese sounding name?  What is there to suggest that she wasn't born in the US?  There is no mention of China and how did you come to the conclusion that she herself might be a transplant tourist from China?
I remain confused.  My assumption would be that she is a researcher or a medical journalist but I don't know that for sure either.

[Zach]

I had read elsewhere that in the Philippines they will allow the donors to be tested at any lab of our choosing and to have American Doctors check everything about the donor.

Sounds fishy to me.
Are you going to send your American doctor to the Philippines to check out the "donor?"

[Chris]

Just something for the rich, over zealous, and dumb to do who have no patience for waiting?

[Hippy]

Monrein, I may be wrong in assuming that Dr. Chen was referring to China , when she writes "going abroad".  But if she really means all the other countries in the world , then she is a nut case. Anyway the main article hasn't been printed yet, but I intend to read it as well as information from that Mitch in the Philippines,fastertransplant@yahoo.com.
 Chris, I do think it is good to get all the information to speed up to normal , getting a kidney transplant. I think that waiting 5 years on a list is not patience but rather insanity. As for being rich, Joe the plumber isn't rich and he could pay for 3 or 4 transplants "overseas".
 Zach, Doctors don't need to travel to examine a patient or donor. They can use Teleconferences or a computer video conference. But who needs that American Doctor anyway, if he can't provide the needed Transplant Surgery.
  Maybe Obama can change this absurd waiting list nonsense with his new ideas on providing Universal Health care.

[monrein]

Monrein, I may be wrong in assuming that Dr. Chen was referring to China , when she writes "going abroad".  But if she really means all the other countries in the world , then she is a nut case. Anyway the main article hasn't been printed yet, but I intend to read it as well as information from that Mitch in the Philippines,fastertransplant@yahoo.com.
 Chris, I do think it is good to get all the information to speed up to normal , getting a kidney transplant. I think that waiting 5 years on a list is not patience but rather insanity. As for being rich, Joe the plumber isn't rich and he could pay for 3 or 4 transplants "overseas".
 Zach, Doctors don't need to travel to examine a patient or donor. They can use Teleconferences or a computer video conference. But who needs that American Doctor anyway, if he can't provide the needed Transplant Surgery.
  Maybe Obama can change this absurd waiting list nonsense with his new ideas on providing Universal Health care.

But Hippy, no one is suggesting that "all the other countries in the world" are involved in selling organs to transplant tourists.  Rather, it would be poor people selling to wealthier people.  Here is a quote from a medical blog about countries involved.

"Given that Organ Transplantation Tourism depends on poor people giving up their organs it is not difficult to imagine the origin and destination of this trade. David Spurgeon (quoting Professor Daar, Canada: BMJ) identifies the Philippines, Iraq, China, India, South Africa, Turkey and Eastern Europe as destinations for transplant tourists. However, the Lancet commentary reports that the representatives of the Declaration of Istanbul have “played major roles in the promulgation” of laws and regulations affecting transplantation tourism in China, Pakistan and the Philippines. Although the Australian website abc.net.au on 12 August 2008, had a story with the headlines: Australia urged to ban China’s ’transplant tourism’. Shimazono quoting an Organs Watch report, identifies the following major countries as “organ importing countries” (origin of tourists): Australia, Canada, Israel, Japan, Oman, Saudi Arabia and the USA."  (http://www.kevinmd.com/blog/2007/04/transplant-tourism.html)

I'll also say that a Universal Health Care system does not ensure an increase in the availability of organs for transplant.  There is still a 5-6 year (and longer in some cases) wait for a cadaveric kidney transplant here in
Canada.
I'm also quite unclear about how a doctor can do an assessment of a potential donor by teleconference or video conference.  My sister-in-law comes here a week from today to do her testing and they need her here in person to complete all of the necessary tests in order to ensure HER safety as much as possible.  Long distance approval would seem to be in the primary self-interest of the wealthier recipient and I wouldn't trust it to protect my loved ones.

One last point.  I am perhaps insane, although people are kind enough not to suggest it too often, but I waited 5 years last time for my cadaver transplant and would wait again even though I technically could travel abroad and do the transplant tourism thing.  I do not judge people who do so, but it is not for me and I would indeed wait patiently even if it is "insane" in your view.

[Zach]

Hippy, I say go to the Philippines and have it done.  Then report back to us with the results. Salamat po.