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Checklist: Passport, Plane Ticket, Organ Transplant

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Checklist: Passport, Plane Ticket, Organ Transplant
Recently, active and proposed US medical insurance programs are taking steps to address the problems of organ availability, long waiting times, and high medical and surgical costs by promoting transplant tourism. Such programs are created explicitly to encourage policy holders to travel to a foreign country for the purpose of obtaining a transplant. Some medical insurance programs have gone as far as to bundle exotic travel and healthcare—transplantation not excluded—into one package. This article details some of the safety and ethics issues with these programs.

Even with living donation a routine practice in the United States (US), the number of donated organs does not meet the demand. As of 19 January 2007, nearly 95 000 patients were waiting for an organ transplant. In 2004, approximately 26 500 organs were transplanted in the US; during the same period, over 7000 patients died waiting for an organ. Over 4000 of these patients were waiting for a kidney. It is projected that by the year 2010, the United Network for Organ Sharing (UNOS) kidney waiting list will have 100 000 patients and the average waiting time will be nearly 10 years. Lengthy waiting times can contribute to increased risk for clinical deterioration, reduced quality of life, and in many cases, removal from the list if their clinical picture significantly deteriorates. Some patients with monetary means have responded to this dilemma by placing themselves on waiting lists at multiple hospitals, thereby increasing their chances of receiving a transplant. Recently, active and proposed US medical insurance programs are taking steps to address the problems of organ availability, long waiting times, and high medical and surgical costs by promoting transplant tourism. Such programs are created explicitly to encourage policy holders to travel to a foreign country for the purpose of obtaining a transplant. Indeed, some medical insurance programs have gone as far as to bundle exotic travel and healthcare—transplantation not excluded—into one package. Here, we detail some of the safety and ethics issues with these programs.

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