The access of non-resident patients to the deceased donor waiting list (DDWL) poses different challenges. The European Committee on Organ Transplantation of the Council of Europe (CD-P-TO) has studied this phenomenon in the European setting. A questionnaire was circulated among the Council of Europe member states to inquire about the criteria applied for non-residents to access their DDWL. Information was compiled from 28 countries. Less than 1% of recipients of deceased donor organs were non-residents. Two countries never allow non-residents to access the DDWL, four allow access without restrictions and 22 only under specific conditions. Of those, most give access to non-resident patients already in their jurisdictions who are in a situation of vulnerability (urgent life-threatening conditions). In addition, patients may be given access: (i) after assessment by a specific committee (four countries); (ii) within the framework of official cooperation agreements (15 countries); and (iii) after patients have officially lived in the country for a minimum length of time (eight countries). The ethical and legal implications of these policies are discussed. Countries should collect accurate information about residency status of waitlisted patients. Transparent criteria for the access of non-residents to DDWL should be clearly defined at national level.

Centro Nazionale Trapianti Istituto Superiore di Sanità Rome Italy

Division of Transplant Surgery Harvard Medical School Brigham and Women's Hospital Boston MA USA

European Directorate for the Quality of Medicines and HealthCare Council of Europe Strasbourg France

Instituto Português de Sangue e da Transplantação Lisbon Portugal

Israel Transplant Center Tel Aviv Israel

Koordinační středisko transplantací Prague Czech Republic

New England Donor Services Waltham MA USA

NHS Blood and Transplant Bristol UK

Organización Nacional de Trasplantes Madrid Spain

Padua University Hospital Padua Italy

Zobrazit více v PubMed

Global observatory on donation and transplantation. Available at: http://www.transplant-observatory.org. Accessed June 2021.

Shimazono Y. The state of the international organ trade: a provisional picture based on integration of available information. Bull World Health Organ 2007; 85: 955.

Delmonico FL, Domínguez-Gil B, Matesanz R, Noel L. A call for government accountability to achieve national self-sufficiency in organ donation and transplantation. Lancet 2011; 378: 1414.

Akoh JA. Key issues in transplant tourism. World J Transplant 2012; 2: 1.

Ambagtsheer FA, Weimar W. Organ trade: knowledge, awareness, and nonlegislative responses. Transplantation 2016; 100: 5.

The declaration of Istanbul on organ trafficking and transplant tourism. Available at: https://www.declarationofistanbul.org/. Accessed June 2021.

Ambagtsheer FA, Zaitch D, Weimar W. The battle for human organs: organ trafficking and transplant tourism in a global context. Global Crime 2013; 14: 1.

Spasovski G, Busic M, Delmonico F. Improvement in kidney transplantation in the Balkans after the Istanbul Declaration: where do we stand today? Clin Kidney J 2016; 9: 172.

Rizvi SAH, Naqvi SAA, Hussain Z, et al. Renal transplantation in developing countries. Kidney Int 2003; 83: S96.

Domínguez-Gil B, Danovitch G, Martin DE, et al. Management of patients who receive an organ transplant abroad and return home for follow-up care: Recommendations from the Declaration of Istanbul Custodian Group. Transplantation 2018; 102: e2.

Resolution CM/Res (2017) on establishing procedures for the management of patients having received an organ transplant abroad upon return to their home country to receive follow-up care. Available at: https://rm.coe.int/1680726fb8. Accessed June 2021.

Babik JM, Chin-Hong P. Transplant tourism: understanding the risks. Curr Infect Dis Rep 2015; 17: 473.

Recommendation Rec (2001)5 of the Committee of Ministers to member states on the management of organ transplant waiting lists and waiting times. Available at: https://search.coe.int/cm/Pages/result_details.aspx?ObjectId=09000016804c901e. Accessed June 2021.

Recommendation Rec (2006)15 of the Committee of Ministers to member states on the background, functions and responsibilities of a National Transplant Organisation (NTO). Available at: https://search.coe.int/cm/Pages/result_details.aspx?ObjectId=09000016805bfeec. Accessed June 2021.

Delmonico FL, Gunderson S, Iyer KR, et al. Deceased donor organ transplantation performed in the United States for noncitizens and nonresidents. Transplantation 2018; 102: 1124.

Charnaya O, Verghese P, Goldberg A, Ladin K, Porteny T, Lanthos JD. Access to transplantation for undocumented pediatric patients. Pediatrics 2020; 146: e20193692.

http://hudoc.echr.coe.int/fre?i=001-58035. Accessed June 2021.

Hall T. Doing harm, allowing harm, and denying resources. J Moral Philos 2008; 5: 50.

Sangiovanni A. Global justice, reciprocity, and the state. Philos Public Aff 2007; 35: 3.

Becker LC. Reciprocity, justice, and disability. Ethics 2005; 116: 9.

Directive 2011/24/EU of the European parliament and of the council of 9 March 2011 on the application of patients’ rights in cross-border healthcare. https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32011L0024&from=EN. Accessed June 2021.