Table 5.

Graft losses among touristsa

PatientTransplant DetailsEvents Surrounding Graft LossTime to Graft Loss
146-yr-old man with living-unrelated kidney transplant in PakistanProlonged ICU hospitalization upon return to United States with multiple complications, including anemia, perinephric fluid collection, CMV viremia, E. coli UTI, C. difficile infection, ARDS, and type 3 acute cellular rejection.After failed courses of Solu-Medrol and IVIG, remained dialysis dependent. Nuclear studies revealed allograft thrombosis; allograft nephrectomy 45 d after transplantation.45 d
235-yr-old woman with deceased-donor transplant in ChinaComplicated postoperative course with an episode of "acute tubular necrosis" and "early acute rejection" treated with a 2-wk course of OKT3Admitted upon return to the United States with acute renal failure requiring hemodialysis and CMV viremiaDespite treatment for CMV, remained dialysis dependent and had allograft pain, requiring allograft nephrectomy122 d
333-yr-old woman deceased-donor kidney transplant in ChinaAdmitted 5 mo after transplantation with fulminant hepatic failure secondary to hepatitis B and renal failure. Underwent a failed liver transplant and subsequently a successful liver-kidney transplant. Protracted and complicated ICU admission and ultimately died of multisystem failure 20 mo after transplantation.154 d
457-yr-old woman with living-related kidney transplant in the PhilippinesDeveloped acute cellular rejection 7 yr after transplantation with underlying chronic allograft dysfunction; underwent allograft nephrectomy 8 yr after transplantation7 yr
  • a ARDS, acute respiratory distress syndrome; C. difficile, clostridium difficile; CMV, cytomegalovirus infection; E. coli, Escherichia coli; ICU, intensive care unit; IVIG, intravenous immunoglobulin; UTI, urinary tract infection