Going Abroad for Transplants Has Risks
Traveling overseas for a transplant carries a host of problems, not the least of which are long-term complications that can kill, a new study suggests.
Infections a Major Problem
It was a mere 25 days after the procedure, on average, that the recipients sought follow-up care in the U.S. Canales notes that at her institution, kidney recipients are generally advised to take it easy for at least six week after transplantation.
In general, the transplant itself was a success. Two people initially rejected their new kidney, but one was treated successfully with antirejection drugs; only one person had to go back on dialysis.
But four of the 10 developed potentially life-threatening complications. One person with a severe wound infection "had pus coming out of his wound at the time of arrival in the U.S. He came off the plane and went straight to the emergency room." In and out of the hospital for three months, the person eventually developed a fungal infection in the brain and died.
Two people developed sepsis, a blood-borne infection marked by high fever; a third developed a viral infection known as cytomegalovirus (CMV) that raises the risk of eye infections and digestive problems. All three recovered.
Transplant Education Is Key
Canales says that follow-up care was hindered by the lack of communication between the foreign transplant surgeon and the U.S. doctors. "In general, we just got a piece of paper saying the kidney transplant went well. We didn't know what medications they were given at the time of transplant or what doses. There was little or no information on the donor," she says.
But with many of those who traveled overseas reluctant to share information about the source of their new organ, Canales doubts that will change anytime soon. Instead, she says, doctors have to take advantage of the fact that many people share, or at least hint at, their intents to go abroad and should educate them about the long-term risks before their journey.
Anthony M. D'Alessandro, MD, director of multiorgan transplantation at the University of Wisconsin in Madison, agrees.
"We know people are looking for ways to get a transplant sooner, but they really have to weigh the risk of staying on the waiting list against something that may be good in the short term but not long term. Education is key," he tells WebMD.
D'Alessandro notes that the situation is getting better in the U.S. "We've had a 17% jump in organ donors in the past two years," he says. "Prior to that the biggest increase in one year was 3%."