High mortality among recipients of bought living-unrelated donor kidneys

Between June, 1984, and May, 1988, 130 patients from three renal units in the United Arab Emirates and Oman went of their own accord to Bombay, where they bought, through brokers, kidneys from living unrelated Indian donors for US$2600-3300. 131 transplants were done, and the 122 patients who survived the perioperative period returned to their original renal units for follow-up. Altogether there were 25 deaths (16 before the end of 3 months, 4 in the next 3 months, and 4 more by the end of the first year), which gave a patient survival rate of 81·5% at 1 year. The patients who died had multiple complications, but infection was the commonest known cause of death. Patients were not properly instructed about their treatment, and little or no information was given to doctors following up the patients, criteria of suitability for transplantation were not strict, and patients were exposed to serious infections (including human immunodeficiency virus infection). In addition, the availability of living-donor programmes slows down attempts to establish cadaver-donor transplant programmes.