Kidney Transplants Sought Abroad Despite Risks

Most tourists go on vacation to relax and sit in the sun. Transplant tourists leave the country to get new kidneys.

New research at UCLA shows that surgeries carried out in foreign countries often come with a lower standard of care, and higher risk of infection for both patients and donors. Yet an increasing number of American patients are traveling abroad for organ transplants over frustration with long waiting times in the US system. Depending on the region of the US and the availability of a tissue match, patients with kidney failure have to wait up to five years for a transplant.

“There aren’t enough kidneys for everyone that wants kidneys,” said David Cohen, Columbia professor of clinical medicine, who published a commentary last month on the research done at UCLA.

When diagnosed with renal failure, patients usually undergo dialysis until a donor is found. A majority of transplants are from deceased donors, so patients have no way of controlling their wait time. “Most people just get on the list and hope they get lucky,” Cohen said.

For those who are unwilling to wait and who have the available funds, “transplant tourism” is becoming a more popular option. Americans travel to places like Iran, China, the Philippines, India, and South America to undergo surgery. Though the buying and selling of kidneys is illegal nearly worldwide, it is not policed well in these countries and the legal consequences are often minimal.

“In China, prisoners get executed and their organs get sold,” said Cohen. According to research, though the prisoners have the right to decide what happens to their organs, there is suspicion that provincial leaders make money off the transaction. “Proving all of this is difficult, though,” he continued.
Cohen explained that though there have been a few cases of organs being forcibly removed from vulnerable people in foreign countries, this is mainly a myth sensationalized in films and TV shows. In the foreign market, a vast majority of kidneys come from people who voluntarily sell their organs to make quick money. “Usually it’s poor people in debt who see they can get about $5,000,” he explained.

Still, many of these impoverished donors do not benefit from the transaction. People who sell their kidneys must take time off from work and are often considered “less employable” because of a social stigma, explained Cohen. Despite financial compensation for their kidney, many donors fall back into debt quickly. “Usually the donors are worse off after they do it,” he said. “Their care isn’t that great and there’s nobody advocating for them.”

The recipients of the transplants also put themselves at risk when choosing to undergo surgery abroad. Compared to U.S. standards, patient care and the screening of donors are generally inferior in locations where transplant tourism takes place. Upon returning to the U.S., many patients must be hospitalized.

“They come back with all sorts of weird infections,” said Cohen. He explained that even when obvious malpractice occurs overseas, not much can be done about it because “over there the legal recourse is pretty minimal.”

Currently, only about 50 percent of families in the US consent to donating the organs of their deceased relative. Education, Cohen said, could potentially increase the number of organ donations, and make people aware of the consequences of transplant tourism.

“People are desperate over here and wherever there’s a crack in the system they exploit it,” Cohen said.