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Canadians seek kidney transplants in poor countries

BMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7300.1446 (Published 16 June 2001) Cite this as: BMJ 2001;322:1446
  1. David Spurgeon
  1. Quebec

    An estimated 30–50 Canadians travel each year to China, India, and the Philippines for kidney transplants because waiting lists for the operation are so long at home; they can be up to six years in Toronto.

    Accurate figures are not available, but medical experts say the practice is quite common. Dr Jeffrey Zaltsman, director of St Michael's Hospital renal transplant programme in Toronto, says “We've had lots of patients who have gone [abroad]. Some tell us and some don't tell us; they just come back with kidneys.”

    Some come back without kidneys, however, despite having paid for them. One patient, who turned up at Dr Zaltsman's office with poor kidney function after having paid for a transplant in India, was found on ultrasound examination to have no evidence of a transplanted kidney despite having a large scar on his abdomen.

    Investigative journalists Lisa Priest and Estanislao Oziewicz reported in the Toronto Globe and Mail newspaper that a Vancouver businessman, Walter Klak, who acts as a middleman between patients and suppliers of kidney operations, said that he had more than 100 patients on his waiting list. They were awaiting operations at a Shanghai hospital where accident victims were taken.

    Buying and selling organs is illegal throughout Canada, but there is no law dealing with Mr Klak's activities as a middleman. No law prevents Canadians going abroad for organs, but some health officials want the criminal code changed to make it illegal.

    Medical experts interviewed by the journalists estimated that Canadians paid between £35700 and £103600 ($50000 and $145000) for transplants in developing countries, a practice that has been condemned by the International Transplant Society and the World Health Organization. Some return without any medical documents describing the operation or donor. Doctors in Canada may be left in the dark about whether donors have been properly screened for infections such as HIV or hepatitis.

    In 1999 a total of 1010 single kidney transplants were performed in Canadian hospitals. In June 2000 almost 3000 patients across the country were waiting for transplants.


    Embedded Image

    Jim Anderson (above) is an east London artist whose work is on display at the Royal London Hospital, Whitechapel. A special exhibition of local artists' work has been organised to mark the refurbishment of the hospital's main entrance foyer and the creation of a new gallery space which runs along the length of the main corridor. The exhibition is on until 27 July.

    (Credit: ULRIKE PREUSS)

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