Section 18. Professional framework for liver transplantation for overseas patients: Traveling for living donor liver transplantation

Catherine S. Kabiling, Chao Long Chen*, Allan Concejero, Chih Chi Wang, Shih Ho Wang, Chih Che Lin, Yueh Wei Liu, Chee Chien Yong, Bruno Jawan, Yu Fan Cheng

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations

Abstract

Background. Liver transplantation (LT) in overseas patients is a sensitive issue because of the possibility of organ trafficking and transplant tourism. In the Istanbul Summit, there was a call to develop standardized professional frameworks to prevent these practices. Objectives. Our objectives are three-fold, to critically evaluate our professional framework, to study the demographic profiles, and to identify the outcome and impact of LT in overseas patients. Methods. Recipient and donor case records, e-mail communications, and medico-legal records were collected and analyzed for management strategy, demographic profile, donor and recipient characteristics, and outcome. Results. Only 5% of our total LT operations were for overseas patients. Forty-Two (79%) were pediatric cases for which 39 (93%) were due to biliary atresia (PG0.001). Sixty-eight percent were from the Philippines. Thirty-seven (70%) of the donors were first-degree relative. The average hospital days of a pediatric living donor liver transplant (LDLT) recipient was 65.48T28.7, and average cost was 44,602 USD. An adult LDLT recipient stayed for 52.09T11.3 days and spent around 75, 013 USD. A donor of pediatric LDLT stayed in the hospital for 17.42T5 days and spent round 8,176 USD. A donor for adult LDLT was admitted for 15.5T4 days and spent an average 9,612 USD. The total cost for recipient and donor were 56,615 USD (range, 28,976Y82,056) for pediatric LDLT and 84,483 USD (range, 64,851Y108,467) for adult LDLT. Actuarial survival rates were 91% at 1 year, 88% at 3 years, and 86% at 5 years and 10 years. Conclusion. Travelling for LDLT may be a wise and cost-effective step for patients with end-stage liver disease seeking alternative ways from their country. Our professional framework is effective to prevent practice of organ trafficking and transplant tourism. It may be useful to develop international guidelines for the practice of LT in overseas patients.

Original languageEnglish
Pages (from-to)S75-S79
JournalTransplantation
Volume97
Issue number8
DOIs
StatePublished - 27 04 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014 by Lippincott Williams & Wilkins.

Keywords

  • Liver transplantation
  • Living donor liver transplantation
  • Medical tourism
  • Transplant tourism
  • Travel for transplantation

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