Many American transplant professionals frown on the practice of transplant tourism where patients travel to countries such as China, India, and the Philippines for their transplantation. These transplant tourists may be subject to sub-standard surgical techniques, poor organ matching, unhealthy donors, and post transplant infections, prompting U.S. health care institutions to refuse treatment of these patients upon return to the U.S.

Currently, the United Network of Organ Sharing (UNOS) reports there are more than 105,000 Americans on the transplant candidate waiting list with more than 15,000 patients awaiting a liver transplant. Furthermore, UNOS data shows a decline in donorship with living donor numbers decreasing by 1.7% and deceased donors down by 1.2% in 2008.

The study authors estimate that more than 400 patients received transplants abroad with 75% of those taking place between 2004 and 2006. Of those transplant tourists, 40% reside in New York and California, and the majority these patients traveled to the PRC, where organs from executed prisoners have been used in transplantations. Although transplant tourism is not held in high regard, the practice violates neither current U.S. law nor the National Organ Transplant Act. Current UNOS policies allow a small percentage of each center's transplants to be allotted for foreign nationals, essentially allowing for transplant tourism within the U.S.

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