Patient access to transplantation with an Internet-identified live kidney donor: a survey of U.S. centers.
BACKGROUND
To investigate legitimate transplantation in the United States with an Internet-identified live donor organ, from the patient's perspective, kidney centers were contacted by a researcher posing as an ideal patient and recipient pair seeking to find a center to perform their transplant.


METHODS
Responses were obtained with fewer than three phone calls and within less than 2 wk from 100 of 206 UNOS listed centers; 42 pediatric or inactive centers were excluded.


RESULTS
A total of 37% (76 of 100) indicated a willingness to consider such a transplant. Eight centers acknowledged having previously performed one, with 100% (8/8) of these indicating that they would still consider future participation.


CONCLUSIONS
Large numbers of Internet-facilitated transplants are not yet being performed in the United States. Because it was possible to elicit a definite answer with 3 or fewer calls at only 49% of centers, we conclude that a significant proportion of centers are not providing easy access to potential donors and recipients. Agreeable centers were clustered geographically, suggesting that multiple factors may be influencing opinions. 100% of agreeable centers required their own standard evaluation of the donor and recipient and indicated that financial exchange between the pair was illegal. We conclude that Internet-based live donor kidney transplants are occurring and have received cautious acceptance at a significant number of legitimate centers. The utility of asking "How did the recipient-donor pair present to our institution" may no longer be relevant. We suggest that every pair seeking access to legitimate transplantation should undergo standardized evaluation with open acknowledgment of the relationship as a modifier.
Friedman
Amy L
AL
Section of Organ Transplantation and Immunology, New Haven, CT, USA. friedmaa@upstate.edu
Lopez-Soler
Reynold I
RI
Cuffy
Madison C
MC
Cronin
David C
DC
D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D020407:Internet; D007668:Kidney; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014481:United States