The outcomes and controversies of transplant tourism-Lessons of an 11-year retrospective cohort study from Taiwan

Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transpl...

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Bibliographic Details
Published in:PloS one 2017-06, Vol.12 (6), p.e0178569-e0178569
Main Authors: Tsai, Daniel Fu-Chang, Huang, Shi-Wei, Holm, Soren, Lin, Yi-Ping, Chang, Yu-Kang, Hsu, Chih-Cheng
Format: Article
Language:English
Subjects:
Adult
Aged
Analysis
Blood & organ donations
Cohort analysis
Dialysis
Ethics
Failure
Female
Graft rejection
Grafting
Grafts
Guidelines
Hazard assessment
Health
Health care policy
Health hazards
Health insurance
Health sciences
Hemodialysis
Hepatocellular carcinoma
Hospitals
Human rights
Humans
Insurance
International organizations
Kidney Transplantation
Liver
Liver cancer
Liver Transplantation
Liver transplants
Male
Medical ethics
Medical research
Medical Tourism
Medicine and Health Sciences
Middle Aged
Mortality
Patients
People and Places
Policies
Reflection
Retrospective Studies
Society
Sound
Surgeons
Survival
Taiwan
Tourism
Transplantation
Transplants
Transplants & implants
Treatment outcome
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Summary:Transplant tourism has increased rapidly in the past two decades, accounting for about 10% of world organ transplants. However it is ethically controversial and discouraged by professional guidelines. We conducted this study to investigate the outcomes and trends of overseas kidney and liver transplantation in Taiwan to provide a sound basis for ethical reflection. The Taiwanese National Health Insurance Research Database was used to identify 2381 domestic and 2518 overseas kidney transplant (KT) recipients from 1998 to 2009 and 1758 domestic and 540 overseas liver transplantation (LT) recipients from 1999 to 2009. Cox proportional hazards models were used to assess the risks of mortality and graft failure. The numbers of overseas transplantation increased after 2000, reached a peak in 2005 and decreased after 2007. Compared to their domestic counterparts, the overseas KT recipients were older, male predominant, with shorter pre-op dialysis period and more comorbidities. Similarly, the overseas LT recipients were older, male predominant and had more hepatocellular carcinoma cases. The 1-, 5-, and 10-year patient survival rates were 96.9%, 91.7% and 83.0% respectively for domestic KT and 95.8%, 87.8% and 73.1% for overseas KT (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0178569