Hello, everyone! I am Hiro, the transplant adviser for Japan Anbis International. Today I will be talking about the current state (as of Jan 2016) of global transplants. Before that I would first like to share the conclusion of the thing all patients want to hear the most; namely, if current transplant tourism is possible. Transplant tourism is possible. There are yet still countries accepting foreign travelers. I hope this news brings relief to all of you! However, in spite of the yearly increase of patients overseas in need of transplants, the environment surrounding this is becoming stricter. What are the laws of each country? In many countries there are established laws concerning organ donation and transplants. Concerning brain death, there are countries that legally consider brain death as dead or there are countries where it is not legally regulated and instead the decision depends on a medical society or medical association. As for organ donation, naturally the wishes of the person in question are most preferred but in cases where the person's wishes are unknown it is typically a decision made by the family (such as the United States, Canada, and Australia). Also, within Europe that are countries that have established laws stating, "if the person in question has not denied organ donation then organ donation is possible" (it is known as an "assumed wish" and is in countries like Spain, Belgium, and Austria). Furthermore, according to the World Health Organization (WHO) in "Organ Transplant Guidelines" (May 1995), the requirements for offering organs are "Preference is given to the person in question. In instances where there are none, it is according to the wishes of the bereaved family." The guideline above shows the following consensus on transplant in internatioal societies. Transplant surgeons cannot get involved in determination of death toward donors; organ-transplant trade is forbidden; recipients need to be selected impartially and fairly. Also as transplant except cadaveric kidney transplant, the guideline regards donors as directly-and-biologically-related parents (first degree of kinship) and siblings (second degree of kinship), and then it expands donors to in terms of histocompatibility grandparents who are unrelated persons (second degree of kinship), uncles and aunts (third degree of kinship), in-laws, cousins and moreover spouses who are totally unrelated persons,
distant relations (in accordance with the Civil Code relatives are defined to a blood relative of the party within the sixth degree of kinship, spouses and a relative by affinity of the party within the third degree.), unrelated persons and other non-family members, and in some countries they are all approved as donors. Circumstances of organ transplants around the world currently are getting tougher due to donor's shortage
every year. WHO released guidelines that "each country needs to make donors by themselves" in 2008 Istanbul declaration. For example, from 2003 until 2007 overseas transplant patients came to be positively received in China. In 2007 the Philippines were elevated as a "transplant tourism" country that attracted patients from overseas, but pressure from WHO resulted in a sudden suspension by President Arroyo in April 2008. Currently in both China and the Philippines there is still talk of transplants, but, unfortunately, these talks are not about legal routes for it. It's important to keep in mind and consider the clear prohibition in laws and executive orders of accepting overseas patients. (In the Philippines at the National Kidney and Transplant Institute there is a cap at 10% for overseas patients.) It's 5% for America, but heading toward discontinuation. Are organ transplants illegal? It's certainly not that it is illegal. However, there are trends that have been going on for a long time. On the internet people calling themselves NPO organizations invest a lot of money to sponsor advertisements as enthusiastic support for organ donation. A normal NPO is a non-profit organization that does not invest in such advertisements. All the patients need to think a little more about such an issue. How can we travel for transplantation safely then? Firstly, we need to know about donors. Donor systems varies depending upon countries. Most countries only allow organ donation from a family or a near relative but some counties allow a third party organ donation in good faith.( Mexico, Jordan, Indonesia, Vietnam, Sri Lanka etc.) We should request an authorized way of donation in these countries. Next, the expenses most patients are concerned about, in these countries you are expected like following, depending on the level of hospitals: $100,000 (One hundred thousand US dollars) for kidney transplant, 250,000. (Two hundred fifty thousand US dollars) for liver transplant. Sanitary services and amenities are provided at best hospitals in that country. Also you don't need to worry about the local languages and any supports over there for 24 hours. I cannot answer all questions more than the above, but please feel free to visit out website and let me explain more for you.
１． Overseas transplant information you truly seek
(A) Do you go through painful dialysis day after day? (B) Or are you in need of a liver transplant with limited life expectancy? (C) Either way, it's a serious matter that affects human life. (D) Do you put up with dialysis because there is no other way? Or because you don't have enough money? Dialysis is said to be the worst treatment, as it cuts a person's life in half. (E) Not being able to receive a transplant in modern medicine means death. (F) No matter how much money you have, if you cannot find a way to obtain a new kidney, the worst fate awaits you.
２． Why are we disclosing this information? (A) I hope to provide true information to patients in need of kidney transplants all over the world. (B) In 2007, after WHO made an announcement in Istanbul, it is almost impossible to obtain information on oversea transplants around the world. (C) However, as law differs from country to country, an overseas transplant itself is not illegal. In some countries only relatives can be donors, while friends or good Samaritans can be donors in others. (D) But where is such a country? Everyone is dying for such information. (E) In this day and age everyone is connected through the Internet. Some may say they can find information online. If so, please try it! You probably cannot find reliable information though these means! It is information requires more in-depth research. (F) We are a medical support company for profits, so of course we charge for providing our support. (G) In addition, 99.9% of the time there is a huge risk even if you have some information. Strangers, unfamiliar companies and organizations... It is almost impossible to avoid such a risk beforehand. (H) In fact, we have been deceived many times since we started business 15 years ago. That's why we understand patients' worries very well. (I) If we consider whether or not there is any risk involved for those of us who provide support, we find similar risks. For instance, when you shop at a supermarket, you bring goods to the cashier and pay them with cash or by a credit card. (J) However, long-distance transactions may involve various forms such as credit, deposit, and deferred payment. (K) Even so, there is no country where they will provide surgeries without guaranteeing payment beforehand. (L) Following our promise with patients, we pay for airfare, obtain housing, look for donors, and pay for medical exams. What about this risk? (M) The saddest thing that has happened is when we lose contact midway. In our Japanese business culture, we rarely lose contact without knowing why. We will never lose contact more than a day at our company. You can communicate with us by phone, mail or Skype without a fail. We have stopped hearing from not only providers in developing countries but also ones in advanced countries. Also, many patients have responded in similar manners. We hope they would tell us why they choose to cease communication with us. (N) So how is it possible to engage in a reliable transactions regarding world-wide information, that is not available even online, and receive support while sitting at home? (O) Our thought process is as follows. It would be best if we can provide a transplant to patients as inexpensive as possible, without going through a broker! (P) You can manage on your own because English is understood everywhere as long as you have information on hospitals! (Q) But we can say that's impossible! (R) This is because transplants are a very sensitive issue. Although there are some countries that allow third-party donations, who would volunteer their organs out of good will? Let's say you look for a donor on your own. But that won't do. You need to have a donor registered in that country with the whole family's consent, accompanied by them, to obtain approval by the ethics committee. We alone can do this as we possess expert knowledge on this issue. We can assure you that we are the only one in the world. (S) We have come up with the best way to proceed while considering patients' risks as well as our risks. (T) First of all, patients speak different languages all over the world. As a native speaker of Japanese, I prefer to speak in my language instead of speaking about information concerning your life in a second language. Thus, I would like to talk to you directly through the closest interpreter to your city (you can bring your interpreter if you like. The fee will be split in half after negotiation). The interpreter will accompany you and speak to me through Skype as I live in Japan. (U) If we can come to agree that we can trust each other, we will take the following steps.
