Tuesday, August 17, 2010

Those seeking black market organs put others at risk

By Pamela Fayerman Vancouver Sun

VANCOUVER — Black market organ transplants put all Canadians at risk, experts say.

The 20 or so desperate Canadians who travel to other countries for the risky procedure each year could contract antibiotic-resistant bacterial infections and bring it back to North America, the researchers say.

With 5,000 delegates attending the 23rd International Congress of The Transplantation Society in Vancouver this week, four experts discussed the many pitfalls of transplant tourism in a panel discussion Monday.

Besides the dire consequences to the health of organ recipients and the public health hazard from new forms of antibiotic-resistant infections, the experts are also concerned about the exploitation of the world's most impoverished people who donate organs to get money.

Dr. Graham Sher, chief executive officer of Canadian Blood Services, said the most recent data he has seen shows that 215 Canadians sought transplants outside Canada from 1995 to 2004.

It is not known how many clandestine transplant operations are being performed in countries including China, India and Pakistan, but medical tourism is believed to be a small industry relative to the 100,000 legitimate transplants performed throughout the world each year.

Yet the consequences of even a small underground industry are grave, experts say.

Dr. Francis Delmonico, a Harvard transplant surgeon and director of medical affairs for The Transplantation Society, said University of Toronto research shows the dire consequences for medical tourists.

The study, led by Dr. Ramesh Prasad, showed that black market kidneys can result in far higher surgical complications, infections, transplant failure and death.

The Prasad study looked at the outcomes of 22 Canadians who travelled to countries throughout Asia and the Middle East for kidneys.

One-third of all the patients who had transplants outside of Canada required immediate hospitalization following their return to Canada, primarily for serious infections.

Another third required eventual hospital admission.

Two patients required repeat transplants and nearly 40 per cent had drug resistant infections.

Another 14 per cent contracted tuberculosis.

In the medical journal Lancet last week, researchers showed that patients from Britain and the United States who underwent medical care in India and Pakistan returned home with gene mutation infections that were resistant to almost all antibiotics.

Earlier this summer, the Centers for Disease Control in the U.S. drew attention to the first cases of such mutations and advised doctors to watch for it in patients who had received care in South Asia.

In order to stem the number of desperate patients seeking organs outside North America, countries around the world have to do more to increase the number of donor organs, experts say.

The first organ transplant was performed in 1954 and since then, transplantation has become such a routine procedure that "we all expect to get an organ if we need one," said Dr. Luc Noel of the World Health Organization which, since 1987, has been helping countries to find ways to crack down on trafficking in human organs.

Delmonico commended Israel for passing legislation which prevents insurance companies there from paying for black market organ transplant procedures.

Canadian doctors have become the first in the world to develop an official policy in which they can refuse to treat patients bent on being medical tourists. Buying and selling livers, kidneys, hearts and other organs is illegal in Canada and throughout the world.

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