Living unrelated (paid) kidney transplantation in Third-World countries: high risk of complications besides the ethical problem.
Due to inadequate cadaveric and living related organ supply, many end-stage renal disease patients go to third-world countries for living unrelated (paid) kidney transplantation. Thirty-four patients who have had transplantations in two centres in India before coming to our centre for post-transplant care and follow-up are reported in this study. In the post-transplant phase at our centre, the mean follow-up period of the patients was 209.7 +/- 137.3 (range 6-450) days. Fourteen of them, having an uneventful course, were followed on an outpatient clinic basis. The rest of the patients were hospitalized because of the following surgical and/or medical complications, during admission: urinary fistula in two patients; lymphocele in three patients; urinary tract obstruction in two patients; decubitus ulcer in one patient; severe wound infection in one patient; subacute myocardial infarction in one patient; acute irreversible vascular rejection in two patients; urinary tract infection in two patients; pneumonia in two patients; congestive heart failure and severe electrolyte disturbance in two patients; post-transplant diabetes mellitus and ketoacidosis in one patient; cyclosporin nephrotoxicity in two patients; cyclosporin nephro-, hepato-, and neurotoxicity in one patient. Plasmodium falciparum malaria in three patients, generalized mucormycosis infection in one patient, and genitourinary aspergillosis in one patient were seen during the first month. Hepatitis B virus infection followed by chronic active hepatitis was diagnosed in two patients, 2 and 4 months after the operation; and Kaposi's sarcoma was noted in another two patients, 1 and 5 months after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)
Sever
M S
MS
Istanbul School of Medicine, Transplantation Unit, Capa/Topkapi/Istanbul, Turkey.
Ecder
T
T
Aydin
A E
AE
Türkmen
A
A
Kiliçaslan
I
I
Uysal
V
V
Eraksoy
H
H
Calangu
S
S
Carin
M
M
Eldegez
U
U
D000293:Adolescent; D000328:Adult; D001228:Aspergillosis / Q000209:etiology; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008288:Malaria / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009091:Mucormycosis / Q000209:etiology; D012306:Risk; D018570:Risk Assessment; D009927:Tissue and Organ Procurement