Experiences, behavior, attitudes and knowledge of Dutch transplant professionals towards patients who travel abroad for kidney transplantation: results of a national survey
L.J. van Balen, F. Ambagtsheer, W. Weimar
Moderator(s): J. Ringers en T.P.J. Bezema
Location(s): Kleine Foyer
Category:
Background Patients from the Netherlands travel abroad for kidney transplants and may return with medical complications. Although travelling abroad does not directly imply an illegal transplant purchase, it is commonly perceived to be an illegal and/or immoral endeavour involving health risks.
Objective We aimed to gain insight into the experiences, attitudes, behaviours and knowledge of Dutch transplant professionals towards patients who travel abroad for alleged illegal transplantations.
Methods Between March and August 2013 a cross-sectional online survey was sent to 546 transplant professionals. These were nephrologists, transplant surgeons, transplant coordinators, nurses, nurse practitioners and social workers.
Results 241 professionals were included (44%): 54% men and 45% women. The median age was 48. Over the last 5 years 43% of transplant professionals had treated patients who travelled outside the EU for a kidney transplant with suspicion or certainty of organ purchase in 70% of cases. 85% understand why patients buy organs; 42% do not think patients should be prosecuted (more men think so), 27% think they should be prosecuted but only 5% would report the patient to the police if purchase is certain and younger professionals are more likely to do so. When professionals are certain of a planned organ purchase, the majority (63%) would not give patients their medical record. More men than women approve of the patient’s purchase and agree with a regulated organ market. We found significant differences within the types of professionals regarding their willingness to refer patients to colleagues (abroad) and their willingness to give patients their medical records. Significant differences within types of professionals were also found in their answer to the question whether organ purchase falls under their secrecy oath. Respondents experience a conflict of duties (65%) when suspicions of purchase arise: by giving the medical record they help facilitate an illegal transplant (n=78); because of their secrecy oath nothing is done to stop the purchase (n=100) and they cannot protect the donor (n=117). Professionals have limited knowledge about how their rights and duties may apply to a case of possible organ purchase; 80% answered that they have a need for guidelines.
Conclusion Our study indicates that transplant professionals need legal clarity and guidance of their rights and duties when confronted with possible illegal organ purchase.