Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers

Abstract Background Due to a shortage of cadaveric organs for transplantation, some Saudi patients seek to purchase kidneys in other countries. However, kidney transplantation (KT) abroad is often associated with negative outcomes. This study shared the experiences of two Saudi transplantation cente...

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Main Authors: Hany M. El Hennawy, Omar Safar, Abdullah S. Al Faifi, Maryam H. El Hennawy, Balqees Alghamdi, Amani Ali, Manar Alqahtani, Mohammad F. Zaitoun, Sharifah A. Alasmari, Ahmed Serageldeen, Konstantinos Fourtounas, Mostafa Ayyad, Ahmed Ali, Mohamed H. Zahran
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04143-x
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author Hany M. El Hennawy
Omar Safar
Abdullah S. Al Faifi
Maryam H. El Hennawy
Balqees Alghamdi
Amani Ali
Manar Alqahtani
Mohammad F. Zaitoun
Sharifah A. Alasmari
Ahmed Serageldeen
Konstantinos Fourtounas
Mostafa Ayyad
Ahmed Ali
Mohamed H. Zahran
author_facet Hany M. El Hennawy
Omar Safar
Abdullah S. Al Faifi
Maryam H. El Hennawy
Balqees Alghamdi
Amani Ali
Manar Alqahtani
Mohammad F. Zaitoun
Sharifah A. Alasmari
Ahmed Serageldeen
Konstantinos Fourtounas
Mostafa Ayyad
Ahmed Ali
Mohamed H. Zahran
author_sort Hany M. El Hennawy
collection DOAJ
description Abstract Background Due to a shortage of cadaveric organs for transplantation, some Saudi patients seek to purchase kidneys in other countries. However, kidney transplantation (KT) abroad is often associated with negative outcomes. This study shared the experiences of two Saudi transplantation centers regarding unrelated KT overseas. Methods This retrospective comparative cohort study included patients who underwent commercial KT abroad (Group I) and local patients who received living unrelated KT between September 2017 and July 2024, with available follow-up for at least one year. The primary outcome was to compare the perioperative outcomes. The secondary outcome was to compare the cumulative graft survival between both groups using cox-regression analysis. Results Group I included 96 patients and group II included 108 patients. Group I had a statistically significant longer 30-day hospital stay (9.4 ± 1.6 vs. 7.9 ± 1 days, P < 0.001). Primary functioning graft was significantly lower in Group I (83.3% vs. 93.5%; p = 0.01). Group I was associated with statistically significant higher incidence of surgical site infection (SSI) (P = 0.03), lymphocele (P = 0.007) and UTI (P = 0.002). The 1-, 2-, 3-, and 5-year cumulative graft survivals were 80%, 79%, 74%, and 54%, respectively in group I compared to 98%, 97%, 90%, and 60%, respectively in group II. [HR = 2, 95% CI = 1.1–3.8, P = 0.02] Conclusion Commercial transplantation graft survival rates are lower, and overall outcomes are worse than those of traditional unrelated transplantation in the midterm. Educating patients about the risks associated with overseas KT and promoting public registration for deceased organ donation could help mitigate this practice. Clinical trial number Not applicable.
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spelling doaj-art-eaf1212ce2db4d7b8ff1513596ef34a12025-08-20T03:48:18ZengBMCBMC Nephrology1471-23692025-05-012611610.1186/s12882-025-04143-xNavigating risks: insights on unrelated overseas renal transplantations from two Saudi centersHany M. El Hennawy0Omar Safar1Abdullah S. Al Faifi2Maryam H. El Hennawy3Balqees Alghamdi4Amani Ali5Manar Alqahtani6Mohammad F. Zaitoun7Sharifah A. Alasmari8Ahmed Serageldeen9Konstantinos Fourtounas10Mostafa Ayyad11Ahmed Ali12Mohamed H. Zahran13Surgery Department, Section of Transplantation, Armed Forces HospitalsUrology Department, Armed Forces HospitalsSurgery Department, Section of Transplantation, Armed Forces HospitalsSurgery Department, Section of Transplantation, Armed Forces HospitalsPharmacy Department, Armed Forces HospitalsNursing Department, Armed Forces HospitalsNursing Department, Armed Forces HospitalsPharmacy Department, Armed Forces HospitalsPrince Sultan Kidney Center, King Salman Armed Forces HospitalPrince Sultan Kidney Center, King Salman Armed Forces HospitalPrince Sultan Kidney Center, King Salman Armed Forces HospitalPrince Sultan Kidney Center, King Salman Armed Forces HospitalPrince Sultan Kidney Center, King Salman Armed Forces HospitalPrince Sultan Kidney Center, King Salman Armed Forces HospitalAbstract Background Due to a shortage of cadaveric organs for transplantation, some Saudi patients seek to purchase kidneys in other countries. However, kidney transplantation (KT) abroad is often associated with negative outcomes. This study shared the experiences of two Saudi transplantation centers regarding unrelated KT overseas. Methods This retrospective comparative cohort study included patients who underwent commercial KT abroad (Group I) and local patients who received living unrelated KT between September 2017 and July 2024, with available follow-up for at least one year. The primary outcome was to compare the perioperative outcomes. The secondary outcome was to compare the cumulative graft survival between both groups using cox-regression analysis. Results Group I included 96 patients and group II included 108 patients. Group I had a statistically significant longer 30-day hospital stay (9.4 ± 1.6 vs. 7.9 ± 1 days, P < 0.001). Primary functioning graft was significantly lower in Group I (83.3% vs. 93.5%; p = 0.01). Group I was associated with statistically significant higher incidence of surgical site infection (SSI) (P = 0.03), lymphocele (P = 0.007) and UTI (P = 0.002). The 1-, 2-, 3-, and 5-year cumulative graft survivals were 80%, 79%, 74%, and 54%, respectively in group I compared to 98%, 97%, 90%, and 60%, respectively in group II. [HR = 2, 95% CI = 1.1–3.8, P = 0.02] Conclusion Commercial transplantation graft survival rates are lower, and overall outcomes are worse than those of traditional unrelated transplantation in the midterm. Educating patients about the risks associated with overseas KT and promoting public registration for deceased organ donation could help mitigate this practice. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04143-xOverseas kidney transplantationCommercial kidney transplantationUnrelated living donor transplantGraft survival
spellingShingle Hany M. El Hennawy
Omar Safar
Abdullah S. Al Faifi
Maryam H. El Hennawy
Balqees Alghamdi
Amani Ali
Manar Alqahtani
Mohammad F. Zaitoun
Sharifah A. Alasmari
Ahmed Serageldeen
Konstantinos Fourtounas
Mostafa Ayyad
Ahmed Ali
Mohamed H. Zahran
Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers
BMC Nephrology
Overseas kidney transplantation
Commercial kidney transplantation
Unrelated living donor transplant
Graft survival
title Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers
title_full Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers
title_fullStr Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers
title_full_unstemmed Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers
title_short Navigating risks: insights on unrelated overseas renal transplantations from two Saudi centers
title_sort navigating risks insights on unrelated overseas renal transplantations from two saudi centers
topic Overseas kidney transplantation
Commercial kidney transplantation
Unrelated living donor transplant
Graft survival
url https://doi.org/10.1186/s12882-025-04143-x
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