Several patients with end-stage renal disease went to Bombay for renal transplantation from nonrelated living donors and then returned to Turkey for posttransplantation follow-up. The aims of this study are to evaluate the long-term results of renal transplantation from nonrelated living donors in Turkish patients with end-stage renal disease and to discuss the ethical and social aspects of nonrelated kidney donation. One hundred and twenty-seven patients (89 males, 38 females; mean age 38.1, range 17–63 years) were investigated retrospectively. None of the patients went to Bombay on our advice. All transplantations were performed between 1991 and 1995. The mean follow-up period after transplantation was 34.2 (range 1–68) months. Graft survival rates were 85, 83, and 57% after 3 months and 1 and 5 years, respectively. Patient survival rates were 94, 93, and 92% after 3 months and 1 and 5 years, respectively. Seven patients died within the first 3 months after the transplantation. Surgical problems, infections, acute rejection, ciclosporin nephrotoxicity, and hepatic problems were common complications. We conclude that medical and surgical complications occur frequently in paid kidney transplantation, but most of these complications can be prevented by adequate preoperative management, and precautionary measures should be taken to prevent commercialization of renal transplantation before the spread of emotionally related living kidney donation.

Keywords:
Organ trading, Non-related living-donor kidneys, Kidney transplantation
1.
Salahudeen AK, Woods HF, Pingle A, Suleyman MNEH, Shakuntala K, Nandakumar M, Yahya TM, Daar AS: High mortality among recipients of bought living-unrelated donor kidneys. Lancet 1990;336:725–728.
2.
Al-Khader AA, Al-Sulaiman M, Dhar JM: Living non-related kidney transplantation in Bombay. Lancet 1990;336:1002.
3.
Çolakoğlu M, Akpolat T, Arık N, Utaş C, Arınsoy T, Sindel Ş, Sungur C, Yasavul Ü, Turgan Ç, Çağlar Ş: Outcome of renal transplantation from foreign unrelated-living donors in Turkey. Nephron 1995;71:244–245.
4.
Friedlaender MM, Gofrit O, Eid A: Unrelated-living-donor kidney transplantation. Lancet 1993;342:1061–1062.
5.
Ivanovski N, Stojkovski L, Cakalaroski K, Masin G, Djikova S, Polenakovic M: Renal transplantation from paid, unrelated donors in India – it is not only unethical, it is also medically unsafe. Nephrol Dial Transplant 1997;12:2028–2029.
6.
Mansy H, Khalil A, Aly TF, Filobbos P, Al-Dusari S, Al-Shareef Z, Shlash S: Outcome of commercial renal transplantation: Two years follow-up. Nephron 1996;74:613–616.
7.
Türkmen A, Sever MŞ, Ecder T, Yıldız A, Aydın AE, Erkoç R, Eraksoy H, Eldegez U, Ark E: Posttransplant malaria. Transplantation 1996;62:1521–1523.
8.
Abu-Romeh SH, Osman N, Rashid A: Living non-related kidney transplantation in Bombay. Lancet 1990;336:1584.
9.
Sever MŞ, Ecder T, Aydın AE, Türkmen A, Kılıçaslan I, Uysal V, Eraksoy H, Çalangu S, Çarin M, Eldegez U: Living unrelated (paid) kidney transplantation in Third-World countries: High risk of complications besides the ethical problem. Nephrol Dial Transplant 1994;9:350–354.
10.
Shohaib SA: Organ trading: A medical or ethical mistake? Nephron 1996;73:106.
11.
Abouna GM: Negative impact of trading in human organs on the development of transplantation in the Middle East. Transplant Proc 1993;25:2310–2313.
12.
Bircan ZE, Buyan N, Olguntürk R, Söylemezoğlu O, Tunaoğlu S, Hasanoğlu E: Myocarditis caused by cytomegalovirus infection in a child with a renal transplant. Nephrol Dial Transplant 1994;9:1803–1804.
13.
Yenen OS: A case of Plasmodium vivax infection transmitted by renal allograft. Nephrol Dial Transplant 1994;9:1805–1806.
14.
Naqvi SAJ: Transplantation in Pakistan. Transplant Proc 1995;27:1469.
15.
Mani MK: Renal transplantation in India. Transplant Proc 1992;24:1828–1829.
16.
Chugh KS, Jha KS: Commerce in transplantation in Third World countries. Kidney Int 1996;49:1181–1186.
17.
Çoker A, Ok E, Tokat Y, Hoşcoşkun C, Kaplan H, Yararbaş Ö: Evaluation of patients transplanted in countries other than Turkey. Transplant Proc 1994;26:2455–2456.
18.
Kandela P: India: Kidney bazaar. Lancet 1991;337:1534.
19.
Akpolat T, Arık N: Living unrelated (paid) renal transplantation. Nephrol Dial Transplant 1994;9:1844–1845.
20.
Davison AM: Commercialization in organ donation. Nephrol Dial Transplant 1994;9:348–349.
21.
Lawrence R: Abuse of live related kidney transplantation. Nephrol Dial Transplant 1997;12:2028.
22.
Daar AS, Salahudeen AK, Pingle A, Woods HF: Ethics and commerce in live donor renal transplantation: Classification of the issues. Transplant Proc 1990;22:922–924.
23.
The Council of the Transplantation Society: Commercialization in transplantation. Transplantation 1986;41:1–3.
24.
Abouna GM, Kumar MSA, Samhan M, Dadah SK, John P, Sabawi NM: Commercialization in human organs: A Middle Eastern perspective. Transplant Proc 1990;22:918–921.
25.
Broumand B: Living donors: The Iran experience. Nephrol Dial Transplant 1997;12:1830–1831.
26.
Akpolat T, Arık N, Arınsoy T, Sungur C, Bakkaloğlu M, Erkan İ, Yasavul Ü, Turgan Ç, Çağlar Ş: High prevalence of antibodies to hepatitis C virus among renal transplant recipients: Correlation with chronic liver dysfunction. Nephron 1993;64:163–164.
27.
Akpolat T, Arık N, Günaydın M, Utaş C, Dilek K, Çağlar Ş, Candan F, Süleymanlar G, Paydaş S, Şen S, Kürşat S, Yeksan M, Akoğlu E, Boran M, Arınsoy T, Bozfakioğlu S, Çamsarı T, Tonbul Z, Vural A, Ataman R: Prevalence of anti-HCV among haemodialysis patients in Turkey: A multicentre study. Nephrol Dial Transplant 1995;10:479–480.
28.
Sesso R, Klag MJ, Ancao MS, Whelton PK, Seidler A, Sigulem D, Ramos OS: Kidney transplantation from living unrelated donors. Ann Intern Med 1992;117:983–989.
29.
Terasaki PI, Cecka JM, Gjertson DW, Takemoto S: High survival rates of kidney transplants from spousal and living unrelated donors. N Engl J Med 1995;333:333–336.
30.
Pirsch JD, Sollinger HW, Kalayoglu M, Stratta RJ, D’Alessandro AM, Armbrust MJ, Belzer FO: Living-unrelated renal transplantation: Results in 40 patients. Am J Kidney Dis 1988;12:499–503.
31.
Haberal M, Gulay H, Tokyay R, Oner Z, Enunlu T, Bilgin N: Living unrelated donor kidney transplantation between spouses. World J Surg 1992;16:1183–1187.
32.
Thiel G: Emotionally related living kidney donation: Pro and contra. Nephrol Dial Transplant 1997;12:1820–1824.
1998
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