title: Organ trafficking for live donor kidney transplantation in Indoasians resident in the west midlands: high activity and poor outcomes.
abstract: BACKGROUND
  Some Indoasian (IA) patients with established renal failure travel abroad for commercial kidney transplantation. We compared the 1-year outcomes of IA patients from one UK region who received overseas transplants with IA patients receiving local living donor (LD) kidney transplantation, deceased donor (DD) transplantation, and dialysis.
  
  
  METHODS
  Between 1996 and 2006, 40 adults were transplanted overseas; 38 were IA, and follow-up data were available on 36 patients. Forty IA patients received LD transplants, and 156 patients received DD transplants locally. A cohort of 120 prospective dialysis patients was also used as a comparator group.
  
  
  RESULTS
  In the overseas cohort, 20 patients (56%) were not active in the UK transplant waiting list at the time of kidney transplantation overseas. One-year graft survival was 87%, and 1-year patient survival was 83%. Composite graft and patient survival was 69.5% at 1 year. In the local LD transplant recipients, patient survival was 97.5% (39 of 40; P=0.03), and graft survival was 97.5% (39 of 40; P=0.06). Composite graft and patient survival was 95% (P=0.003). In the overseas group, 42% had major infections compared with 15% in the local group (P=0.02). One-year graft survival for DD transplant was 84.6% (132 of 156), and 1-year patient survival was 93% (145 of 156; P=NS and P=0.06, respectively). In the dialysis group, 1-year patient survival was 96.7% (116 of 120; P=0.001).
  
  
  CONCLUSIONS
  IA patients who choose to travel overseas for kidney transplantation have poor clinical outcomes and should be counseled accordingly.
authors.affiliation: Department of Renal Medicine, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom. nithya.krishnan@uhcw.nhs.uk
authors.forename: Nithya
authors.initials: N
authors.lastname: Krishnan
authors.forename: Paul
authors.initials: P
authors.lastname: Cockwell
authors.forename: Pavan
authors.initials: P
authors.lastname: Devulapally
authors.forename: Barbara
authors.initials: B
authors.lastname: Gerber
authors.forename: Raj
authors.initials: R
authors.lastname: Hanvesakul
authors.forename: Robert
authors.initials: R
authors.lastname: Higgins
authors.forename: Andrew
authors.initials: A
authors.lastname: Ready
authors.forename: Paul
authors.initials: P
authors.lastname: Carmichael
authors.forename: Kerry
authors.initials: K
authors.lastname: Tomlinson
authors.forename: Shiv
authors.initials: S
authors.lastname: Kumar
authors.forename: Jyoti
authors.initials: J
authors.lastname: Baharani
authors.forename: Indranil
authors.initials: I
authors.lastname: Dasgupta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001208:Asia; D002681:China; D015331:Cohort Studies; D003415:Crime; D005260:Female; D006085:Graft Survival; D006801:Humans; D007194:India; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000628:therapy*; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence / Q000379:methods*; D014195:Travel; D016896:Treatment Outcome; D006113:United Kingdom