title: A questionnaire based assessment of numbers, motivation and medical care of UK patients undergoing liver transplant abroad.
abstract: BACKGROUND
  Medical tourism, where patients travel abroad intentionally to access medical treatment, is a growing trend. Some of these patients travel to undergo organ transplantation. This study aims to quantify the number of UK patients who undergo liver transplantation abroad, assessing their motivations and management.
  
  
  METHODS
  Questionnaires were sent to all seven UK liver transplant units enquiring about liver patients receiving transplant abroad. Included were questions on destination, motivation, and pre and post-transplant care.
  
  
  RESULTS
  Responses were received from six of the seven transplant centres (86%). A total of 12 patients were identified as having undergone liver transplantation overseas. The top destinations were India, China and Egypt. Four units responded to questions regarding pre-transplant screening. One unit reported Hepatitis B and C screening not taking place. Four units responded to questions regarding post-transplant antimicrobial therapy. This revealed examples of patients inappropriately not receiving valganciclovir, co-trimoxazole, anti-fungal treatment and Hepatitis B immunoglobulins.
  
  
  CONCLUSIONS
  UK patients are undergoing liver transplant abroad, albeit in small numbers. Pre and post-transplant management of these patients is of a lower standard than that provided to those undergoing transplantation in the UK. Information transfer between overseas and UK based transplant teams is poor.
authors.affiliation: Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, S10 2JF, England, UK. Electronic address: Ben.kerrwinter@gmail.com.
authors.forename: Ben
authors.initials: B
authors.lastname: Kerr Winter
authors.affiliation: Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, S10 2JF, England, UK.
authors.forename: Anand
authors.initials: A
authors.lastname: Odedra
authors.affiliation: Department of Infection and Tropical Medicine, Royal Hallamshire Hospital, Sheffield, S10 2JF, England, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Green
mesh_terms: D000328:Adult; D002681:China; D004534:Egypt; D005260:Female; D006801:Humans; D007194:India; D016031:Liver Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D057193:Medical Tourism / Q000523:psychology / Q000706:statistics & numerical data*; D009042:Motivation; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Hepatology; Infectious diseases; Medical tourism; Transplantation