Kidney 'Shoppers' beware

People who travel abroad for a new organ risk major complications

June 13, 2006

Canadian doctors are warning that people desperate enough to travel abroad for kidney transplant surgery are at greater risk of suffering complications when they return to Canada, including serious infections and death.

"It is happening in Vancouver and Toronto. Those are the centres where they have the longest waiting times," says Dr. Jeffrey Zaltzman, director of the transplant program at St. Michael's Hospital and an assistant professor of medicine at the University of Toronto.

He says many countries offer "kidney shopping" -- transplantation of kidneys from unrelated living donors who are paid for the organ.

Zaltzman and his colleagues reviewed the cases of 22 Canadian citizens who were treated at St. Michael's after receiving a new kidney from a living unrelated donor outside North America and Western Europe. The transplants were done in Pakistan, China, Iran, India, the Philippines and Turkey.

The kidney recipients were assessed at St. Michael's 13 days to six months after the surgery, and seven of the 22 patients needed immediate admission to hospital.

Six had an episode of organ rejection, despite the use of standard medications to suppress the immune system. Eleven patients, more than half the total, developed severe, system-wide infections. And three people lost their new kidney.

Overall, 90 per cent of the patients were still alive after one year, and 82 per cent of transplanted kidneys were still functioning. In comparison, 2001 Canadian Organ Replacement Registry data shows kidney transplants are less risky and more successful in this country, with a one-year patient survival of 98 per cent and a one-year organ survival of 92 per cent.

Dr. Anthony Smith, a professor of surgery/urology at the University of New Mexico in Albuquerque, says the high infection rates among kidney shoppers may be due to over-use of immune-suppressing drugs.

However, the study researchers say it may be that many different factors are contributing to these high complication rates. Many of these kidneys are acquired through a "middle man" and there is a significant black market in which no real regulations are in place.

"It is just a theory but some hospitals have higher fungal spore rates in their ventilation systems and these are infecting the transplant patients early after surgery," says Dr. Alexandra Perks, a study co-investigator and urology fellow at St. Michael's.

With files from The Medical Post.

Copyright © 2006 Rogers Media Inc.

This article posted July 15, 2006.