Outcomes of Commercial Renal Transplantation: A Canadian Experience

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Abstract
Financial compensation in exchange for live kidney donation is prohibited in Canada. However, patients in Canada with end-stage renal disease and without a suitable biologically or emotionally related live donor face substantial waiting times on lists for deceased donor kidneys, and so may therefore choose to acquire organs from a live donor in a procedure performed outside Canada as part of a commercial transaction. We describe the clinical outcomes in such patients transplanted between 1998 and 2005, managed after their surgery at a single Canadian transplant center. Patient and graft survival at three years were significantly worse in this group compared to recipients of live biologically related (P<0.0001) and emotionally related transplants (P<0.01) performed in Canada during this period. A number of different surgical and infectious complications were seen, requiring frequent and often lengthy hospitalization. Patients considering this method of acquiring live-donated kidneys should be counseled of the inherent risks and possible adverse outcomes including diminished dialysis-free survival.