216.5: International travel for organ transplantation from deceased donors: a survey of global activity (1 Jan 2023-31 Aug 2024).

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Introduction: Annual data from the Global Observatory on Donation and Transplantation suggest that approximately 20% of transplants for non-resident patients involve deceased donors (DDs).(1) However, little is known about who travels for organ transplantation from DDs or which organs they receive. We report here on data pertaining to DD transplants that were collected as part of the 2024 International Travel for Organ Transplantation (ITOT) Survey study, which explored transplant professionals’ most recent experiences of providing care for recipients or living donors (LDs) involved in ITOT. Methods: An international anonymous survey of transplant professionals was conducted online (16 Sep-15 Dec 2024). The questionnaire (available in English, French, Mandarin and Spanish) assessed respondents’ most recent experiences (between 1 Jan 2023 and 31 Aug 2024 inclusive) of each of four potential case types: provision of care to an incoming or outgoing LD or transplant recipient. Considering their most recent experience of each type, respondents were asked to provide information about the country of residence of LDs and recipients, the country in which donation and transplantation took place, the organ(s) transplanted, type of donor (deceased or living), and if the recipient was a child or adult. Data were analysed with descriptive statistics. Results: 353 individuals from 64 countries completed the survey. 309 were clinically active between 1 Jan 2023 and 31 Aug 2024, of whom 149 (48%) had provided care for ≥1 incoming or outgoing transplant recipient. Of the 164 most recent incoming or outgoing recipient cases reported, 30% (n=49) involved DD transplants; 33% (n=16) of these involved kidney transplants (25% lung, 18% heart, 12% liver, 4% kidney-liver, 6% kidney-pancreas, intestinal, or pancreas; 2% preferred not to answer (PNA)). Adults comprised the majority of DD transplant recipients (67%; 31% children, 2% PNA), and most (57%) received transplants in the public sector (31% private; 12% unsure). Recipients of DD transplants were from 33 countries, who received transplants in 22 different countries; regions of origin and destination are shown in Table 1. Conclusion: While ITOT involving DD transplantation may represent a life-saving opportunity for some patients with organ failure, it also raises concerns about equity in access to care and national or regional self-sufficiency. This survey indicates that DD transplants may comprise nearly a third of ITOT activities, and approximately 30% take place in private healthcare settings. This highlights the importance of transparency in reporting of DD transplant activity data at the national level and in disclosure of policies governing access to and allocation of DD organs.1. GODT (Global Observatory on Donation and Transplantation). 2025. Organ Donation and Transplantation Activities 2023 Report. Available at:https://www.transplant-observatory.org/wp-content/uploads/2025/02/2023-data-global-report-20022025.pdf

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