Document Detail

Outcome of living unrelated (commercial) renal transplantation.
MedLine Citation:
PMID:  11576362     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Due to inadequate cadaveric and living related organ supply, many end-stage renal disease patients go to Third World countries for commercial transplantation, although the high risk of complications is well established and ethical arguments debate this practice. METHODS: The midterm outcome of 115 patients who had been commercially transplanted in various countries and admitted to our center for post-transplant care and follow-up between 1992 and 1999 was retrospectively analyzed. Data considering the transplantation practice and post-transplant course were collected from the patient files. Outcome of these patients was compared with those with a living related transplant performed at our center. RESULTS: The patients (91 male and 24 female; mean age of 42 +/- 12 years) were transplanted in India (N = 106), Iraq (N = 7), and Iran (N = 2). The mean follow-up period was 64.5 +/- 23.9 months. Post-transplant course was complicated by numerous surgical and/or medical complications, and many of the latter were unconventional infections caused by malaria, invasive fungal infections, and pneumonia due to various opportunistic pathogens. Overall, 52 patients still have functioning allografts, while 22 lost their grafts, 20 died, and 21 were lost to follow-up. Graft survival rates at two, five, and seven years were 84, 66, and 53%, respectively, for the study group, while it was 86, 78, and 73% for living related transplantations performed at our center (P = 0.036). Patient survival rates for the same periods were 90, 80, and 74% for the study group and 90, 85, and 80% for the living related transplantations (P = 0.53). CONCLUSIONS: Besides the ongoing ethical debate, commercial transplantation carries a high risk of unconventional complications, and despite that the patient survival rate is comparable, graft survival is worse than conventional living related transplantations at the midterm.
M S Sever; R Kazancioğlu; A Yildiz; A Türkmen; T Ecder; S M Kayacan; V Celik; S Sahin; A E Aydin; U Eldegez; E Ark
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  60     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-09-28     Completed Date:  2002-01-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1477-83     Citation Subset:  E; IM    
Department of Nephrology and Department of Surgery, Istanbul School of Medicine, Capa-Istanbul, Turkey.
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MeSH Terms
Developing Countries
Graft Rejection
Graft Survival
Infection / etiology
Kidney Transplantation* / adverse effects,  mortality
Living Donors*
Middle Aged
Postoperative Complications
Retrospective Studies
Risk Factors
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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