Navigating Risks: Insights on Unrelated Overseas Renal Transplantations from Two Saudi Centers

Abstract

<title>Abstract</title> <bold>Background:</bold> Due to a shortage of cadaveric organs for transplantation, some Saudi patients seek to purchase kidneys in other countries. However, kidney transplantation (KT) abroad is often associated with negative outcomes. This study shared the experiences of two Saudi transplantation centers regarding unrelated KT overseas. <bold>Methods:</bold> This retrospective comparative cohort study included patients who underwent unrelated KT abroad (Group I) and local patients who received living unrelated KT from September 2017 to July 2024, with follow-up for at least one year at AFHSR and Tabouk. <bold>Results: </bold>we studied 204 patients, including 96 who underwent commercial KT (Group I) and 108 who received living unrelated KT(Group II), with an average follow-up of 42 months. Immediate graft function was lower in Group I (83.33%) than in Group II (93.51%; p=0.0104). One-year patient survival was significantly lower in Group I (94.8%) than in Group II (100% in Group II (p=0.0167), along with poorer long-term kidney function. <bold>Conclusion:</bold> commercial transplantation patient survival rates are lower, and overall outcomes are worse than those of traditional unrelated transplantation in the midterm. Educating patients about the risks associated with overseas KT and promoting public registration for deceased organ donation could help mitigate this practice.