Hsu C.-C.Lee C.-H.SHI-WEI HUANGHuang S.-W.Yang W.-C.Chang Y.-K.DANIEL FU-CHANG TSAIKuo K.N.2020-02-262020-02-2620111320-5358https://www.scopus.com/inward/record.uri?eid=2-s2.0-79951988763&doi=10.1111%2fj.1440-1797.2010.01426.x&partnerID=40&md5=2fe72a6da993e9f08f171f49865f8802https://scholars.lib.ntu.edu.tw/handle/123456789/464913Aim: Overseas kidney transplantation has often been reported to have unsatisfactory outcomes. This study aims to compare post-transplantation outcomes between overseas and domestic kidney transplant (KT) recipients in Taiwan. Methods: The Taiwanese National Health Insurance Research Database was used to identify 310 domestic and 643 overseas KT recipients, who survived for longer than 1 month after the transplantation, in a cohort of 45 453 chronic haemodialysis patients in 1997-2002. Cox proportional hazards models were used to assess risks of mortality and graft failure. Results: The 1, 3 and 5 year survival rates for domestic KT recipients were 96.5%, 93.3% and 91.6%, respectively, while those for overseas KT recipients were 94.9%, 87.9% and 77.1%, respectively (P = 0.015). For the overseas group, those who received a KT before 2001 had significantly higher hazard ratios of mortality and graft failure (2.85 and 1.71, respectively). However, for those receiving a KT in 2001-2002, no significant outcome difference could be found between overseas and domestic recipients. Conclusion: The risk disparity between overseas and domestic KT recipients is mainly attributable to when the transplantation was performed. In attempting to dissuade potential recipients from organ trafficking, merely emphasizing the previously acknowledged poor outcomes no longer suffices as a valid reason. ? 2011 The Authors. Nephrology ? 2011 Asian Pacific Society of Nephrology.kidney transplantation; organ trafficking; post-transplantation outcome[SDGs]SDG3lymphocyte antibody; methylprednisolone; thymocyte antibody; adult; article; brain abscess; cerebrovascular disease; comorbidity; controlled study; cytomegalovirus infection; data base; diabetes mellitus; endocarditis; female; graft failure; graft recipient; graft rejection; graft survival; hematoma; hemodialysis patient; hepatitis B; hepatitis C; herpes simplex; herpes zoster; human; hydronephrosis; hypertension; incidence; ischemic heart disease; kidney cancer; kidney infection; kidney transplantation; kidney vein thrombosis; liver abscess; lymphocele; major clinical study; male; medical tourism; meningitis; mortality; outcome assessment; overseas kidney transplantation; postoperative complication; postoperative infection; priority journal; risk assessment; septicemia; survival rate; survivor; Taiwan; tuberculosis; urinary tract obstruction; urinoma; Adult; China; Female; Graft Survival; Health Services Accessibility; Healthcare Disparities; Humans; Kaplan-Meier Estimate; Kidney Failure, Chronic; Kidney Transplantation; Living Donors; Male; Medical Tourism; Middle Aged; National Health Programs; Outcome and Process Assessment (Health Care); Proportional Hazards Models; Renal Dialysis; Risk Assessment; Risk Factors; Survival Rate; Taiwan; Time Factors; Treatment Outcome; Young Adultjournal article10.1111/j.1440-1797.2010.01426.x210919222-s2.0-79951988763