Outcome of kidney transplantation using organs from executed prisoners: is it justified beyond the ethical issue?
BACKGROUND
Kidney transplantation using organs from executed prisoners is a subject of controversy from the viewpoint of ethics. However, few reports have addressed the clinical outcome beyond the ethical issue.


METHODS
Between January 1990 and September 2004, a total of 435 kidney transplant recipients (group M) who underwent transplantation in 26 different hospitals in China were followed up at our hospital. It is believed that all the organs came from executed prisoners. The clinical data were retrieved and compared to those of 200 kidney transplant recipients (group T) who underwent transplantation in our hospital during the same period.


RESULTS
There was no significant difference between these 2 groups (T vs. M) in terms of hepatitis B virus infection (10.5% vs. 12.1%) or surgical complication rate (6.5% vs. 5.6%). The 1st-year acute rejection rate was significantly lower in group M (31.1% vs. 24.5%, p=0.015). The 1-year, 5-year, and 10-year patient survival rates were 94.3%, 89.5%, and 85.2%, respectively, for group T and 92.6%, 83.6%, and 76.7%, respectively, for group M (p>0.05); the corresponding graft survival rates were 91.4%, 82.6%, and 66.9%, respectively, for group T and 91.6%, 80.0%, and 61.4%, respectively, for group M (p>0.05). When patients were stratified according to the year of transplantation, patients who underwent transplantation between 2000 and 2004 had significantly better graft survival rates in both groups.


CONCLUSIONS
We conclude that kidney transplantation using organs from executed prisoners had a clinical outcome similar to that of transplantation performed in our hospital during the same period.
Shu
Kuo-Hsiung
KH
Division of Nephrology, Department of Medicine, Taichung Veterans General Hospital, and School of Medicine, Chung-Shan Medical University, Taichung, Taiwan, ROC. khshu@vghtc.gov.tw
Wu
Ming-Ju
MJ
Chen
Cheng-Hsu
CH
Cheng
Chi-Hung
CH
Lian
Jong-Da
JD
D000328:Adult; D000367:Age Factors; D005260:Female; D006085:Graft Survival; D006509:Hepatitis B / Q000453:epidemiology / Q000635:transmission; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D009927:Tissue and Organ Procurement / Q000941:ethics*; D016896:Treatment Outcome