Health professionals: don’t buy kidney from abroad

Having a transplant in Pakistan. Going to the Philippines just to get a new kidney. This is the extent to which a very small number of Chicago-area dialysis patients will go in order to get off dialysis. And many health professionals think it's wrong.

"If you listen to your doctor's opinion, that will put some breaks on," said Margaret Westbrook, renal social worker at De Vita Lincoln Park dialysis center. She explained that doctors are generally against the practice.

The problem, said Dr. Lainie Ross, a pediatrician and clinical medical ethics professor at the University of Chicago, lies more in the risk to the kidney donor than the kidney recipient. Many of those who go abroad to get transplants buy them illegally. Ross rejects the idea of buying and selling organs, mainly because of the hardship on donors.

People who are willing to sell their organs are generally impoverished and often live in the Third World, making follow-up treatment difficult and sometimes impossible. In the United States and most other countries, organ transplants occur on a donation-only basis. Transplant candidates here generally receive a kidney from either the wait list or a loved one willing to donate. The wait list is 5-6 years in Illinois, according to Westbrook.

In the meantime, people must undergo dialysis to filter their blood the way a healthy kidney would, a time-consuming treatment that involves hours hooked up to a machine in a clinic. Dialysis can result in fatigue and in the beginning can cause nausea and vomiting.

It was to avoid this tedious process that one of Westbrook's patients decided to go to Pakistan for a transplant.

"Dialysis was hard on her. She wanted a chance to do better," Westbrook said.

Somehow the patient got her insurance to pay for the procedure, Westbrook said, befuddled. Insurance usually does not pay for dialysis patients getting foreign transplants. Westbrook has seen three to four Americans of Filipino descent consider going to the Philippines for a transplant, only to realize they would have to pay for expensive anti-rejection medication upon return. So they stayed in the United States and stayed on dialysis.

"There's no vacation until you get a kidney," said Beatrice, a Chicago-area registered nurse who has been on dialysis for four hours, three times a week, for the past 2 1/2 years. She has been on the kidney wait list for a year. Because her daughter is young and recently married and her son plays sports, she decided not to ask them for a kidney.

"I have a friend who is being tested right now to see if she wants to give me one," said Beatrice, who asked that her last name not be used.

Beatrice would never consider getting a kidney from abroad. She said she is afraid that the kidney would not be well-tested and healthy. Lara Tushla, a transplant social worker for Rush University Medical Center, agrees.

"We have so little information about what happened," Tushla said, about surgeries conducted in other countries. An American doctor will not know what happened during the surgery nor what medication the patient received afterwards, she said.

Transplant facilities want to know as much information as possible. This includes making sure that a kidney donor has not been secretly coerced or paid to give up an organ.

Since July, all facilities that want to be certified Medicare transplant centers have had to have living donor advocates, according to Tushla. These are individuals who are not affiliated with the center and who look out for the donors' best interests.

More than 16,000 kidneys were transplanted in the United States in 2007. There is no record of how many patients went abroad in search of transplants.