International Travel for Organ Transplantation: What ISHLT Members Should Know
The International Society for Heart and Lung Transplantation (ISHLT) supported the 2024 global survey on International Travel for Organ Transplantation (ITOT), conducted by the ITOT Research Collaborative. Alongside several other international transplant societies, ISHLT helped disseminate the survey to its members, contributing to a growing body of evidence aimed at better understanding the scope and implications of transplant-related travel worldwide. While the full study is currently under journal review, early findings provide a valuable snapshot of how transplant tourism is experienced in contemporary clinical practice, and why it matters for our community.
A Routine Part of Clinical Practice
Among more than 350 respondents from 64 countries, over half reported caring for at least one patient involved in international transplant travel, with a total of 256 cases described. These findings suggest that ITOT is not an isolated or rare phenomenon, but rather something many transplant professionals encounter in the course of routine care.
Not Limited to Living Donation
Although transplant tourism is often associated with living donor kidney transplantation, the survey highlights a more complex picture. Approximately 30% of cases involved deceased donor transplantation, underscoring that ITOT intersects not only with donor-recipient relationships, but also with organ allocation systems and national policies governing access to deceased donor organs.
Relevance to Heart and Lung Transplantation
Heart and lung cases represented a smaller proportion of reported activity—approximately 14%—reflecting the broader global distribution of transplant types. While limited in number, these cases reinforce that international travel for transplantation is not confined to abdominal organs and may be encountered by ISHLT members across clinical settings.
Ethical and System-Level Considerations
Several findings point to broader ethical and health system challenges:
- A substantial portion of ITOT activity occurs in private healthcare settings, raising questions about oversight and transparency.
- In living donor cases, most donors were reported to have a genetic relationship to recipients, though the mechanisms for verifying these relationships remain unclear.
- Nearly one-quarter of traveling recipients were children, highlighting the complexity of cross-border care in vulnerable populations.
Together, these observations emphasize the need for continued dialogue around equity, donor protection, and continuity of care for patients who cross borders for transplantation.
Looking Ahead
The ITOT Research Collaborative plans to repeat and expand this survey in 2026, enabling trend analysis and deeper exploration of the motivations and systems underlying transplant travel. ISHLT looks forward to continuing to support efforts that advance understanding in this important area. As a global society committed to improving care for patients with advanced heart and lung disease, ISHLT recognizes that transplant activity increasingly occurs within an interconnected international landscape. These early findings highlight the importance of thoughtful engagement, ongoing research, and shared ethical frameworks to guide practice in this evolving space.