International Travel for Organ Transplantation: 2024 Multinational Survey of Routes, Organs, and Donor Types

Abstract

BACKGROUND: International travel for organ transplantation (ITOT) reportedly affects ≥2% of global solid organ transplant activity, yet detailed information about ITOT participants, organ types, travel configurations, and clinical settings remains scarce. Previous research has focused on living donor (LD) kidney transplantation for adults, often in the context of organ trafficking, leaving significant gaps in understanding of contemporary ITOT activities. METHODS: A cross-sectional, international online survey was conducted between September 16 and December 15, 2024. Health professionals with experience caring for organ donors or transplant recipients were recruited via professional societies, social media, and personal networks. Participants reported on their most recent experiences of caring for incoming or outgoing transplant recipients and LDs involved in ITOT between January 1, 2023, and August 31, 2024. Data were analyzed using descriptive statistics. RESULTS: Three hundred fifty-three respondents from 64 countries completed the survey; 166 (54%) of the 309 clinically active respondents had cared for ≥1 ITOT patient during the study period. Among 164 recipient cases, most involved adults (74%), kidney transplants (57%), and LD transplants (59%), with 40% occurring in private healthcare settings. Children comprised 23% of recipient cases. At least 164 unique travel routes were identified spanning 45 destination countries, with recipients originating from ≥69 countries and LDs from ≥54 countries. CONCLUSIONS: ITOT is a geographically diverse, global phenomenon. The substantive proportion of pediatric cases, deceased donor transplants, and private-sector procedures underscores the need for strengthened national and international data collection, governance frameworks, and equitable access policies to address the ethical and clinical challenges of ITOT.