New Definition of Transplant Tourism

K idney transplantation is the treatment of choice for patients with end-stage renal disease (ESRD). Improvement in surgical care, tissue typing, and immuno-suppression management has dramatically improve the outcome of kidney transplant recipients. With all of these achievements, organ shortage globally is one the challenges facing trans-plantation. One step for meeting this need is utilization of living unrelated from volunteer friends and emotionally related (husband or wife), the so-called " altruistic donation. " Globally , kidney transplantation from unrelated-living donors considered the major donor source. The main reason for expansion of this source was the need of poor people for money so their kidney was used as a commodity. At this point, the influence of sociocultural factors on organ donation and transplantation is a major concern. There was not enough volunteer to donate the kidney so the recipients had to pay the donors, the vendors and brokers for the kidney. The demand for organ transplants in industrial countries is rising much faster than the supply of organs donated through traditional means. In response, a small but growing number of the world's poor people are offering their body parts for transaction , and kidneys are the most commonly purchased organs [1]. One hope was transplantation from deceased donors, but this solution did not solve all of the problems. In some countries the concept of brain death was not accepted [2]. In other countries, health care professionals did not believe to transplant deceased donor kidney. For instance, in a recent paper by Qsama Al and colleagues, it is mentioned that " more than half of the physicians (59.7%) and technicians (57.4%) assumed that organs can be bought and sold in the country " [3]. This approach indeed exists in most of the Middle East countries and was the basis for transplant commer-cialism and tourism. According to WHO, " transplant tourism " refers to patients travelling across the borders to be transplanted elsewhere [4]. People tend to travel for transplantation, either because it is not available in their home country, such as Tajikistan and Azerbaijan, or if the facilities are adequate in their home land, there are not enough organs available. Transplant tourism takes place in two different situations: 1) in very well developed countries with long waiting list, and 2) in underdeveloped countries with no prohibitory regulations for buying and selling the kidney but the people are indigent and have to make …