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      Strengthening Global Efforts to Combat Organ Trafficking and Transplant Tourism: Implications of the 2018 Edition of the Declaration of Istanbul

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          Abstract

          The 2018 Edition of the Declaration of Istanbul on Organ Trafficking and Transplant Tourism (DoI) provides an updated set of principles and definitions to guide policymakers and health professionals working in organ donation and transplantation. A draft of the new edition was circulated to the public and transplant professionals through an online consultation process, which also sought feedback on a draft explanatory article that explained the principles and discussed some of their practical implications. Both drafts were revised in response to feedback from participants in the consultation. We present here the discussion article, which is intended to assist stakeholders in applying the principles of the DoI by providing more detailed information about the meaning and potential implications of implementing the DoI in various contexts.

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          Organ trafficking and transplant tourism and commercialism: the Declaration of Istanbul.

          (2008)
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            Organ trafficking and transplant tourism: the role of global professional ethical standards-the 2008 Declaration of Istanbul.

            D A Budiani-Saberi, Adeera Levin, Dominique Martin … (2013)
            By 2005, human organ trafficking, commercialization, and transplant tourism had become a prominent and pervasive influence on transplantation therapy. The most common source of organs was impoverished people in India, Pakistan, Egypt, and the Philippines, deceased organ donors in Colombia, and executed prisoners in China. In response, in May 2008, The Transplantation Society and the International Society of Nephrology developed the Declaration of Istanbul on Organ Trafficking and Transplant Tourism consisting of a preamble, a set of principles, and a series of proposals. Promulgation of the Declaration of Istanbul and the formation of the Declaration of Istanbul Custodian Group to promote and uphold its principles have demonstrated that concerted, strategic, collaborative, and persistent actions by professionals can deliver tangible changes. Over the past 5 years, the Declaration of Istanbul Custodian Group organized and encouraged cooperation among professional bodies and relevant international, regional, and national governmental organizations, which has produced significant progress in combating organ trafficking and transplant tourism around the world. At a fifth anniversary meeting in Qatar in April 2013, the DICG took note of this progress and set forth in a Communiqué a number of specific activities and resolved to further engage groups from many sectors in working toward the Declaration's objectives.
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              Donor kidney exchanges.

              Edgar Milford, J Goguen, Martha Pavlakis … (2004)
              Kidney transplantation from live donors achieves an excellent outcome regardless of human leukocyte antigen (HLA) mismatch. This development has expanded the opportunity of kidney transplantation from unrelated live donors. Nevertheless, the hazard of hyperacute rejection has usually precluded the transplantation of a kidney from a live donor to a potential recipient who is incompatible by ABO blood type or HLA antibody crossmatch reactivity. Region 1 of the United Network for Organ Sharing (UNOS) has devised an alternative system of kidney transplantation that would enable either a simultaneous exchange between live donors (a paired exchange), or a live donor/deceased donor exchange to incompatible recipients who are waiting on the list (a live donor/list exchange). This Regional system of exchange has derived the benefit of live donation, avoided the risk of ABO or crossmatch incompatibility, and yielded an additional donor source for patients awaiting a deceased donor kidney. Despite the initial disadvantage to the list of patients awaiting an O blood type kidney, as every paired exchange transplant removes a patient from the waiting list, it also avoids the incompatible recipient from eventually having to go on the list. Thus, this approach also increases access to deceased donor kidneys for the remaining candidates on the list.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Transplant Direct
                Journal ID (iso-abbrev): Transplant Direct
                Journal ID (publisher-id): TXD
                Title: Transplantation Direct
                Publisher: Lippincott Williams & Wilkins
                ISSN (Electronic): 2373-8731
                Publication date Collection: March 2019
                Publication date (Electronic): 22 February 2019
                Volume: 5
                Issue: 3
                Electronic Location Identifier: e433
                Affiliations
                [1 ] School of Medicine, Deakin University, Geelong, VIC, Australia.
                [2 ] Research Group Personal Rights and Property Rights, University of Antwerp, Antwerp, Belgium.
                [3 ] Organización Nacional de Trasplantes, Madrid, Spain.
                [4 ] European Directorate for the Quality of Medicines & HealthCare, Council of Europe, Strasbourg, France.
                [5 ] Transplant Programs, Public Health System, Guatemala City, Guatemala.
                [6 ] Department of Surgery, University of Cape Town, Cape Town, South Africa.
                [7 ] Gould School of Law and Keck School of Medicine, University of Southern California, Los Angeles, CA.
                Author notes
                [*]Correspondence: Dominique E. Martin, PhD, School of Medicine, Deakin University, Geelong Waurn Ponds Campus, Locked Bag 20000, Geelong, VIC 3220, Australia. ( Dominique.martin@ 123456deakin.edu.au ).
                Article
                Publisher ID: TXD50347 Accession ID: 00008
                DOI: 10.1097/TXD.0000000000000872
                PMC ID: 6411225
                PubMed ID: 30882038
                SO-VID: 044c8454-6949-4323-8b44-ed494221bf37
                Copyright © Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                Date received : 16 December 2018
                Date revision received : 6 January 2019
                Date accepted : 8 January 2019
                Page count
                Pages: 0
                Categories
                Subject: 012
                Subject: Ethics
                Custom metadata
                OPEN-ACCESS TRUE

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