Travel for transplantation is a complex phenomenon. Although in certain instances unethical and linked to transplant tourism, there are legitimate reasons for traveling to receive an organ transplant abroad, including family reasons, transnational co-operation agreements or access to better transplant services for related donor–recipient pairs. However, at present, very limited data is available on the international scope of the phenomenon, the profile of donors and recipients, the quality of the transfer of care, the impact on origin and destination countries, and potential risks.
In 2016, the Council of Europe established the Network of National Focal Points (NFP) on Travel for Transplantation. This network is composed of reference persons, designated by countries and based at existing national transplantation organisations and/or Ministries of Health, tasked with collecting rigorous and comprehensive data on recipients and/or donors who travelled abroad in the context of a transplant procedure. They are also in charge of increasing awareness among health authorities and healthcare professionals on transplant-related crimes and developing national protocols and codes of conduct to provide an adequate framework within the medical field to prevent, detect and report transplant-related crimes, including the training of healthcare staff likely to encounter them in their professional practice. Importantly, they act as a reference person to exchange and disseminate information at national and international level on transplant-related crimes and help establish multidisciplinary synergies and a multi-agency approach to ensure an effective fight against transplant-related crimes. Currently, 35 countries have designated a NFP, including countries outside the Council of Europe borders.
In June 2017, the Registry on International Travel for Transplantation Activity (RITTA) was launched. NFP submit information annually on all patients who received an organ transplant abroad, as well as non-resident donor-recipient pairs who underwent a transplant procedure in the reporting country. Currently, RITTA includes information on 479 transplant procedures, including pseudoanonymized information about recipients, donors, transplant teams, suitability and reasons for referral for transplantation abroad, organ transplanted, status of the recipient on their home country waiting list, quality of the transfer of care, etc. Thanks to this detailed information, the network can analyse the possible legitimacy of the procedures.
The international exchange of information on these patients is helping to better understand the phenomenon of travel for transplantation, assess its dimensions and identify possible hotspots of transplant tourism deserving careful investigation by the countries concerned. In addition, it is helping to gain better knowledge of the profile of donors and recipients, the quality of the transfer of recipient care and its impact on post-transplant outcomes.