title: Patients seeking alternatives to the long waiting list: a reality faced by transplant physicians.
abstract: The need for deceased donor organs for kidney transplantation in the United States continues to increase. The increasing demand has fueled desperate attempts by patients to circumvent the long waiting list of the United Network for Organ Sharing. We report 4 patients with end-stage kidney disease who sought and obtained a live donor kidney transplant outside the United States. In each case, a nephrologist was following up with the patient regularly. Each patient experienced significant unexpected adverse events after the transplant surgery. Desperate attempts to obtain an organ are common and are likely to continue. Although patients with end-stage renal disease who obtain an organ transplant at an unregulated transplant center can have successful outcomes, transplant physicians should be aware of the common practice and should advise their patients of potential complications associated with acquisition of organs through means that circumvent standard oversight by the United Network for Organ Sharing and by institutions.
authors.affiliation: Sharp Memorial Hospital, San Diego, California, USA.
authors.forename: Dianne
authors.initials: D
authors.lastname: McKay
authors.forename: Steven R
authors.initials: SR
authors.lastname: Potter
authors.forename: Terry
authors.initials: T
authors.lastname: Behrend
authors.forename: Frank
authors.initials: F
authors.lastname: Stella
authors.forename: Steven
authors.initials: S
authors.lastname: Steinberg
mesh_terms: D000328:Adult; D001208:Asia; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D006084:Graft Rejection; D006801:Humans; D038622:Internationality; D016030:Kidney Transplantation / Q000009:adverse effects*; D008288:Malaria / Q000209:etiology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D014195:Travel; D014376:Tuberculosis / Q000209:etiology; D014481:United States; D014850:Waiting Lists