van Balen L J, Ambagtsheer Frederike, Ivanovski N, Weimar W
1 Department of Internal Medicine, Section of Nephrology and Transplantation, Erasmus MC University Hospital Rotterdam, Rotterdam, the Netherlands.
2 University of St Cyril and Methodius, Medical Faculty Skopje, Republic of Macedonia.
Prog Transplant. 2016 Dec;26(4):328-334. doi: 10.1177/1526924816667951. Epub 2016 Sep 20.
Patients travel worldwide for paid kidney transplants. Although transplantations abroad are not always illegal, they are commonly perceived to be illegal and unethical involving risks.
We aimed to describe the motivations and experiences of patients who traveled abroad for paid kidney transplantations and to examine how these transplantations were facilitated.
We interviewed 22 patients who traveled from Macedonia/Kosovo, the Netherlands, and Sweden for paid kidney transplantations between years 2000 and 2009.
Patients traveled because of inadequate transplant activity in their domestic countries and dialysis-related complaints. However, 6 patients underwent preemptive transplantations. Cultural factors such as patients' affinity with destination countries, feelings of being discriminated against by the health-care system, and family ties also help explain why patients travel abroad. Seven of the 22 patients went to their country of origin. They were able to organize their transplantations by arranging help from family and friends abroad who provided contacts of caregivers there and who helped cover the costs of their transplants. The costs varied from €5000 to €45 000 (US$6800-US$61 200). Seven patients paid the hospital, 5 paid their doctor, 4 paid a broker, and 6 paid their donors.
Research should include interviews with brokers, transplant professionals, and other facilitators to achieve a full picture of illegally performed transplantations.
患者前往世界各地进行有偿肾脏移植。尽管海外移植并非总是非法的，但人们普遍认为其涉及风险，是非法且不道德的。
我们旨在描述出国进行有偿肾脏移植的患者的动机和经历，并研究这些移植是如何得以促成的。
我们采访了22名在2000年至2009年间从马其顿/科索沃、荷兰和瑞典出国进行有偿肾脏移植的患者。
患者出国是因为其本国移植活动不足以及与透析相关的不适。然而，有6名患者接受了预防性移植。文化因素，如患者对目的国的亲近感、被医疗系统歧视的感受以及家庭关系，也有助于解释患者为何出国。22名患者中有7人前往其原籍国。他们通过安排国外家人和朋友的帮助来组织移植，这些人提供当地护理人员的联系方式，并帮助支付移植费用。费用从5000欧元到45000欧元不等（6800美元至61200美元）。7名患者向医院付费，5名向医生付费，4名向中间人付费，6名向捐赠者付费。
研究应包括对中间人、移植专业人员和其他促成者的访谈，以全面了解非法进行的移植情况。
