Medical Tourism: Organ Trafficking and Kidney Transplantation

2011 ◽  
pp. 147-160
Keyword(s):  
Kidney Transplantation ◽  
Medical Tourism ◽  
Organ Trafficking

scholarly journals P1841THE JOURNEY OF KIDNEY TRANSPLANTATION IN EGYPT: STILL EXTRA-MILES TO GO

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mohamed Elrggal ◽  
Mohamed Gendia ◽  
Rowan Saad Zyada ◽  
Ali Moustafa Shendi Mohamed
Keyword(s):  
Kidney Transplantation ◽  
Organ Transplantation ◽  
Organ Transplant ◽  
Legal Framework ◽  
Organ Shortage ◽  
Organ Transplants ◽  
Organ Trafficking ◽  
Human Organ ◽  
Transplant Tourism ◽  
Transplant Program

Abstract Background and Aims Kidney transplantation is the renal replacement therapy of choice for patients with end-stage kidney disease. Egypt is a developing country with social, religious and demographic characteristics having enormous impact on the development and progress of its own national transplant program. Method A web-based review of relevant bibliography: articles and textbooks, reporting the progress in the transplant practice in Egypt and its legislations was conducted. Results Kidney transplantation started in Egypt about 43 years ago when the first transplant was performed at Mansoura Urology and Nephrology Center (UNC) in March 1976. The practice of kidney transplantation in Egypt has then evolved over the years. While about ten thousand transplants were performed from 1976 to 2011, the annual mean number of kidney transplantation between 2011 and 2016 increased to 1100 cases/year. The number of transplant centers has also grown from 12 in 1997 to 35 currently licensed centers. However, Egypt is still lacking a national transplant registry data. The legal framework developed over the last decade towards establishing a national transplant program. Until 2010, organ transplantation was only regulated by the professional code of ethics and conduct of the Egyptian Medical Syndicate. Representatives of the Istanbul Declaration met with the Egyptian Minister of Health and Egyptian Society of Nephrology leaders in Cairo in October 2008; since then, Egypt has been working to terminate illegal practices associated with organ transplantation, organ trafficking and transplant tourism. The first legislation for a national organ transplant program “The executive list for law number 5 of the year 2010 regarding regulating human organ transplants” was then issued after approval by the parliament. The law established “The Higher Committee for Organ Transplants” which includes 7 - 11 experts and is responsible for regulating and supervising all organ and tissue transplant procedures in the country. The new law criminalizes organ trafficking and set strict penalties for physicians, hospitals and medical facilities performing illegal organ transplant procedures. In 2017, the legislation has been further modified to make the penalties even harsher “Law number 142 of the year 2017 modification of some articles in law number 5 of the year 2010 regarding regulating human organ transplants”. Transplantation practice is still limited to live transplants. The cadaveric transplant program has not yet been put into action despite the new 2010 legislation has set the legal framework, yet lacking a clear definition of the legal death. Cadaveric transplantation was performed twice in Egypt in 1992 at Cairo (kasr El Aini hospital) from 2 criminals after execution in Alexandria. This was faced with social anger and rejection which led to legal restrictions for non-living organ procurement at that time. Barriers to establishment of a national transplant program in Egypt include cultural and religious rejection of deceased donation, organ shortage, and long waiting time in national transplant centers. Conclusion Despite the recent ameliorations in the current Egyptian transplant practice, the overall progress has been slow. This can be attributed to a complex interaction between social, religious and financial factors. Further advances are vital to reduce the burden implied by the state-funded dialysis therapy and to demolish organ trafficking and transplant tourism. As such, state efforts would continue to further improve the living donor and to implement the deceased donor transplantation programs.

Patient care without borders: a systematic review of medical and surgical tourism

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
Brittany M Foley ◽  
Jack M Haglin ◽  
Joshua Ray Tanzer ◽  
Adam E M Eltorai
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Medical Tourism ◽  
Ethical Issues ◽  
Resistant Bacteria ◽  
Wait Times ◽  
Complication Rates ◽  
Organ Trafficking ◽  
Ethics And Economics

Abstract Background Medical tourism (MT) is an increasingly utilized modality for acquiring medical treatment for patients globally. This review assimilates the current literature regarding MT, with particular focus on the applications, ethics and economics. Methods A systematic review of MEDLINE and PubMed Central databases for publications relating to MT from 2005 to 2018 yielded 43 articles for this review. Results Patients seeking elective bariatric, cosmetic and orthopedic surgery abroad are motivated by significantly lower costs, all-inclusive vacation packages and reduced wait times. Complication rates as high as 56% include infection, poor aesthetic and functional outcome and adverse cardiovascular events. Cross-border reproductive care has steadily increased due to less restrictive policies in select countries; however, the depth of research on outcomes and quality of care is abysmal. Stem cell therapy promise treatments that are often not well researched and offer minimal evidence of efficacy, yet patients are drawn to treatment through anecdotal advertisements and a last sense of hope. Transplant surgery sought to decrease wait times carries many of the similar aforementioned risks and may contribute to the practice of organ trafficking in countries with high rates of poverty. Patients and countries alike are motivated by a plethora of factors to engage in the MT industry but may be doing so without accurate knowledge of the quality, safety or potential for economic gain. Safety is of utmost importance to prevent surgical complications and the spread of treatment-resistant bacteria. Conclusions MT is growing in popularity and complexity. The lack of standardization in its definition and regulation leads to difficulty in epidemiologic and economic analysis and ethical issues of informed consent and health equity. The findings of this review may be used by the stakeholders of MT, including patients and providers, to enhance informed decision-making and quality of care.

1872: The Efficacy of Deoxyspergualin and Plasmapheresis for Antibody-Mediated Acute Rejection After Kidney Transplantation

2004 ◽  
Vol 171 (4S) ◽  
pp. 494-494
Author(s):  
Michio Michio Nojima ◽  
Tetsuro Yoshimoto ◽  
Atsushi Nakao ◽  
Takuo Maruyama ◽  
Hidekazu Takiuchi ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection

1860: Morphologic Alterations of Bladder and Intestinal Segment Following Bladder Augmentation and Kidney Transplantation

2004 ◽  
Vol 171 (4S) ◽  
pp. 491-492
Author(s):  
William C. Nahas ◽  
Paulo R. Gianini ◽  
Luiz B. Saldanha ◽  
Eduardo Mazzucchi ◽  
Joannis Antonopoulos ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Bladder Augmentation ◽  
Intestinal Segment

1949: Six Month Randomized Study Comparing Cyclosporine Microemulsion with C2 Monitoring and Tacrolimus in De Novo Kidney Transplantation

2004 ◽  
Vol 171 (4S) ◽  
pp. 515-515
Author(s):  
Felipe G. Balbontin ◽  
Bryce Kiberd ◽  
Philip Belitsky ◽  
Dharm Singh ◽  
Albert Fraser ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
De Novo ◽  
Randomized Study ◽  
C2 Monitoring ◽  
Cyclosporine Microemulsion

Impact of ABO-Incompatible Living Donor Kidney Transplantation on Patient Survival

2020 ◽  
Vol 76 (5) ◽  
pp. 616-623 ◽  
Author(s):  
Allan B. Massie ◽  
Babak J. Orandi ◽  
Madeleine M. Waldram ◽  
Xun Luo ◽  
Anh Q. Nguyen ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Patient Survival ◽  
Donor Kidney ◽  
Living Donor Kidney Transplantation ◽  
Donor Kidney Transplantation ◽  
Living Donor Kidney
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