Paid Organ Donation: Case Report and Review of the Literature on Health Implications for Kidney Donors and Recipients

The shortage of organs for use in transplantation has contributed to the development of an international commercial market for organ transplantation. Unfortunately, transplant tourism (TT) is associated with risks for surgical complications, poor graft outcome, increased mortality, and infectious complications. TT increases the risk of several viral (HIV and hepatitis B and C viruses), bacterial (Mycobacterium tuberculosis, Pseudomonas sp., Enterococcus sp., Escherichia coli, and Acinetobacter sp.), fungal (Aspergillus sp., Zygomycetes, Ramichloridium sp., Scedosporium apiospermum, and Trichosporon sp.), and parasitic (Plasmodium sp., Trypanosoma cruzi and Strongyloides sp., and Microsporidia sp.) infections. This paper presents a case report of an anonymous patient who travelled to Pakistan and underwent a commercial kidney transplant. He developed infection from extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC). Moreover, we reviewed all published cases of bacterial, viral, and fungal infections in kidney transplant recipients who bought their organs abroad.