title: De novo malignancy is associated with renal transplant tourism.
abstract: Despite the objections to transplant tourism raised by the transplant community, many patients continue travel to other countries to receive commercial transplants. To evaluate some long-term complications, we reviewed medical records of 215 Taiwanese patients (touring group) who received commercial cadaveric renal transplants in China and compared them with those of 321 transplant recipients receiving domestic cadaveric renal transplants (domestic group) over the same 20-year period. Ten years after transplant, the graft and patient survival rates of the touring group were 55 and 81.5%, respectively, compared with 60 and 89.3%, respectively, of the domestic group. The difference between the two groups was not statistically significant. The 10-year cumulative cancer incidence of the touring group (21.5%) was significantly higher than that of the domestic group (6.8%). Univariate and multivariate stepwise regression analyses (excluding time on immunosuppression, an uncontrollable factor) indicated that transplant tourism was associated with significantly higher cancer incidence. Older age at transplantation was associated with a significantly increased cancer risk; however, the risk of de novo malignancy significantly decreased with longer graft survival. Thus, renal transplant tourism may be associated with a higher risk of post-transplant malignancy, especially in patients of older age at transplantation.
authors.affiliation: Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Meng-Kun
authors.initials: MK
authors.lastname: Tsai
authors.forename: Ching-Yao
authors.initials: CY
authors.lastname: Yang
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Lee
authors.forename: Chi-Chuan
authors.initials: CC
authors.lastname: Yeh
authors.forename: Rey-Heng
authors.initials: RH
authors.lastname: Hu
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
mesh_terms: D000328:Adult; D002102:Cadaver; D002681:China; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D057193:Medical Tourism; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000209:etiology*; D012307:Risk Factors; D013624:Taiwan; D014019:Tissue Donors; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000209:etiology; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents