transplant tourism

Patients and donors travel globally for transplantation purposes. This is not necessarily illegal. The 2008/2018 Declaration of Istanbul distinguishes between (legal) travel for transplantation and (unethical) transplant tourism:

"Travel for transplantation is the movement of persons across jurisdictional borders for transplantation purposes. Travel for transplantation becomes transplant tourism, and thus unethical, if it involves trafficking in persons for the purpose of organ removal or trafficking in human organs, or if the resources (organs, professionals and transplant centres) devoted to providing transplants to non-resident patients undermine the country's ability to provide transplant services for its own population."

In practice, it has proven to be next-to-impossible to distinguish travel for transplantation from transplant tourism. Transplant tourism is difficult to establish due to its legal complexity, jurisdictional loopholes and the lack of cross-border collaboration. There has also been critique against the transplant community's condemnation of transplant tourism. While transplant tourism is publicly condemned and can involve severe medical risks for patients and donors, there is emerging evidence that it is tolerated in practice.

 

Selected reading

• Declaration of Istanbul Custodian Group. Patient Brochure. Thinking of buying a kidney? At www.declarationofistanbul.org
• Martin, D. E., Van Assche, K., Domínguez-Gil, B., López-Fraga, M., Garcia Gallont, R., Muller, E., Capron, A. M. (2019). A new edition of the Declaration of Istanbul: updated guidance to combat organ trafficking and transplant tourism worldwide. Kidney International, 95(4), 757-759. doi:10.1016/j.kint.2019.01.006
• Evans, R. W. (2008). Ethnocentrism is an unacceptable rationale for health care policy: A critique of transplant tourism position statements. American Journal of Transplantation, 8(6), 1089-1095.
• Friedlaender, M. The right to sell or buy a kidney: are we failing our patients? The Lancet. 2002; 359(9310)

 

Empirical studies

• AlRahbi, F. and I. Alsalmi (2020). "Commercial Kidney Transplantation: Participants' Attitudes and Perceptions." Nephrol. Dial. Transplant. 35: 1978-1978.
• Ambagtsheer, F. and Van Balen, B. ‘I’m not Sherlock Holmes’: Suspicions, secrecy and silence of transplant professionals in the human organ trade. European Journal of Criminology. 2020; 17(6) 764–783
• Van Balen, L. J., et al. (2016). "Interviews With Patients Who Traveled From Macedonia/Kosovo, The Netherlands, and Sweden for Paid Kidney Transplantations." Progress in Transplantation 26(4): 328-334.
• Berglund, S. and S. Lundin (2012). ‘I had to leave’: Making Sense of Buying a Kidney Abroad. The Body as a Gift, Resource, and Commodity: Exchanges Organs, Tissues and Cells in the 21st Century. Gunnarson M. and F. Svenaeus. Huddinge, Södertörn Studies in Practical Knowledge: 321–342.
• Scheper-Hughes, N. (2011). "Mr Tati's holiday and João's safari - Seeing the world through transplant tourism." Body & Society 17(2-3): 55-92.
• Huang, C. H., et al. (2011). "Motivations and decision-making dilemmas of overseas liver transplantation: Taiwan recipients' perspectives." Transplant Proc 43(5): 1754-1756.
• Leung, S. S. H. and A. T. Y. Shiu (2007). "Experience of Hong Kong patients awaiting kidney transplantation in mainland China." Journal of Nursing and Healthcare of Chronic Illness 16(11c): 341-349.