Background/Aim: While the ethical aspects of transplant tourism have received much attention recently, less has been written about the medical safety of this practice. We retrospectively evaluated the outcomes of patients who purchased organs internationally and presented to our center for follow-up care.

Methods: We report the outcome parameters of 182 local recipients of unrelated kidney vendor transplants presenting to our institute between 1986 and 2012. Their outcome was compared with 88 recipients of living-related donor transplants matched for age, gender and transplant duration as controls.

Results: Age of commercial recipients was 47.01 ± 12.8 years with Male % of 64.3. The country of transplant was Philippines (n = 62), Pakistan (n = 31), India (n = 27), Iran (n = 27) and Egypt (n= 21). Comparison of commercial recipients with controls showed high co morbidities (P = 0.01) with hepatitis-C (n=2 vs. 0) and hepatitis-B (n=2 vs. 0) and cytomegalovirus (n=4 vs. 1). Donor age was 25.9 ± 3.8 vs. 34.6 ± 8.6 years (P = 0.0001). Biologic agents induction in 58 (31.9%) vs. 88 (100%) (P = 0.00001), acute rejections in 42 (23.1%) vs. 14 (15.9%) (P = 0.04), while recurrent rejection in 12 (28.6%) vs. 4 (7.1%) (P = 0.01), surgical complications; lymphocele 15 (8.2%) vs. 0 (0%) (P = 0.0001), ureteral obstruction 5 (2.7%) vs. 0 (0%) (P = 0.007), hematoma 4 (2.2%) vs. 1 (1.1%) (P = 0.06) and recurrent urinary tract infection 18 (9.9%) vs. 6 (6.8%) (P = 0.3). Overall 1- and 10-year graft survival was 91% and 18% vs. 98% and 56%, respectively (P = 0.001). Total deaths were 36 (19.8%) vs. 14 (15.9%) (P = 0.8).

Conclusion: Although recent developments increased success in renal transplantation, receiving a kidney from a paid living donor at a commercial transplant center still carries great risks for the recipient.

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