Domestic transplant tourism is a phrase used to describe the concept of traveling inside the U.S. but outside your home area, or outside of your state, to obtain an organ transplant. Occasionally, patients find the need to travel for transplant. Sometimes they don’t have transplant services in their area, or their local hospital may not have the specialists or equipment necessary for their complex diagnosis. A transplant center outside of their state might be more experienced or be the only one who offers a plan for their particular disease. Sometimes, patients travel to areas where the organs are more plentiful so they can be transplanted more quickly. The choice of where to be listed for transplant and where to receive your organ is a personal one and patients make the choice to travel if it is best for their situation.
In a letter to the editor published in the journal Liver Transplantation titled “Analysis of the Nature and Frequency of Domestic Transplant Tourism in the United States”, the authors examine the statistics of patients who travel for their transplant. The hope of this analysis is to understand the numbers and the reasons for travel in order to help make more educated decisions about future organ allocation policies in the U.S. Prior to this article, much of the study regarding transplant tourism has been conducted on patients traveling between countries, not within their own country.
The authors of this letter studied liver transplant patients who received a deceased donor between January 1 and December 31 of 2017. Patients were excluded if they were transplanted at a veteran’s hospital, transplanted in their state of residence or in a neighboring state. The authors found that of the 318 patients who were included in the study, nearly half of them traveled to one of four liver transplant programs – Mayo Clinic in Florida, Mayo Clinic in Arizona, Mayo Clinic in Minnesota and Ochsner Clinic in Louisiana.
The reasons for traveling for transplant vary. Some patients don’t have a transplant center in their state so they must travel for services. Sometimes insurance plays a part in where people are covered for surgeries, so they must travel to gain their highest benefit levels. There are also situations where insurance companies have contracts with hospitals, so the patients must travel to a certain hospital for their care. Patients can also research the best hospitals for their needs. Online statistics can help patients determine which hospitals have the best outcomes, fastest transplant rates and the most experience in transplantation.
Whatever your reason for travel, keep in mind that you’re not alone. Many patients travel to Mayo Clinic and other transplant centers around the country to get the care they need. Recently in our blog and discussion group, we answered questions about how to navigate travel during this complex time in your journey. Hopefully as researchers and physicians study this trend more, the policies governing transplant will evolve as travel needs change for patients.
Did you travel for your transplant surgery? If so, was it your decision or was it based on factors out of your control?
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I am from Texas, I am not sure why I am at Mayo in Rochester Minnesota. I am at mayo for the type of cancer and treatment that was needed. Mayo in Arizona and Florida are closer. Non the less the Mayo was one of 3 choices for me. The other 2 where out of Texas also. My Dr at CTRC of San Antonio. Cancer therapy research center. Choose Mayo. I am very glad they did. I am 4 months post transplant. I am Blessed
I originally traveled from Arkansas to Mayo Rochester due to my rare liver disease and unnecessary major surgeries to address it at home. Immediately I had confidence in the knowledge, skills and resources that Mayo offers and wanted to go nowhere else. After several years on the liver transplant list in Rochester, my hepatologist was concerned about the risk of complications that would prevent a transplant. Wait time in Rochester was indeterminate so he spoke to me about transferring to Mayo Jacksonville. There the wait time was estimated at two months. Once I was listed in Jacksonville, I waited two weeks for a cadaver liver. Care for my disease and transplant were of similar quality in Jax and the weather was warmer! Thankful I was given that option. Next week I return to Rochester for my 14th annual checkup.
I was waiting for a liver transplant in Kentucky at UK in 2008. Complications developed due to PSC (Primary Sclerosing Cholangitis) and my transplant team told me that I needed to be at the Mayo Clinic in Rochester to see a specialist there. However, I missed my appointment because of acute kidney failure and being in ICU. I was flown from Kentucky to Mayo on a frigid Friday night in February 2009.
I am forever grateful for the UK doctors who knew where I needed to be and made the decision to send me to Mayo, and for the doctors, in fact everybody, who took care of me at Mayo.
I received a simultaneous liver and kidney transplant in April 2009.
Rochester is almost like a 2nd home and I return annually.
MikeJones, Congratulations on another transplant anniversary! Safe travels, to my transplant friend.