Q:MY wife is thinking about going to China to have a kidney transplant. She suffers from chronic kidney failure and needs dialysis three times a week. We have been told the chance of finding a donor in Hong Kong is slim. She has been on the waiting list for about two years. We know donated kidneys in China sometimes come from executed prisoners, but for us, this is not a deterrent. What is your opinion? Dr Rose writes: It is true that the availability of kidneys is better in China than in most other Asian countries. But one must carefully weigh the risks associated with this procedure.
For the past decade, kidney transplants have been performed in China for overseas patients who have chosen to become recipients of kidneys donated mostly from prisoners.
It is not known whether informed consent has been obtained from these 'donors' or their families, or whether tests are done to detect for blood-borne diseases, such as hepatitis and AIDS.
It is difficult to assess the morbidity and mortality rates of transplants done in China as information is not widely published and few 'outsiders' have been allowed to witness and evaluate the procedures firsthand.
It is generally thought that while surgeons may have a high level of skill, operative and post-operative hygiene is not up to the standards of most developed, industrialised countries. In addition, post-operative nursing support and care are less than optimal.
It is also known that patients are advised to bring immunosuppressive drugs from their own country, since these medications are not easily available in China.
It is important to remember many patients maintain a relatively high quality of life on weekly dialysis treatments and should not rush to have transplants under less than ideal conditions. Unless your wife is clinically deteriorating and considered by her physician to be 'terminal', she should think hard before crossing the border.
