International travel for overseas transplantation (ITOT) is a practice in which individuals travel overseas with the intent of obtaining a transplanted organ. The potential risks for transplant recipients and donors and the ethical concerns regarding organ procurement has necessitated the founding of international bodies to actively identify and oppose illegal forms of the practice. In 2008, a summit convened by The Transplantation Society and the International Society of Nephrology established the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, allowing for standardised identification of illegal activity in the sphere of transplantation, complementing international efforts to oppose organ trafficking. There is presently no systematic registration of Australian patients who have received a transplant overseas, making it difficult to quantify ITOT involving Australians. The purpose of this survey is to review of the nature and number of Australians participating in ITOT and compare with current data available from the Australia and New Zealand Dialysis and Transplant Registry (ANZDATA). The study design was a retrospective descriptive survey, distributed to 540 Australian nephrologists, transplant physicians and surgeons via Transplant Society of Australia and New Zealand (TSANZ) and Australia and New Zealand Society of Nephrology (ANZSN). To preserve anonymity, the survey was entirely de-identified, both for the respondent and for the patient being reported. Participation was voluntary and informed consent was sought. Returned physical responses were stored in a secure locked cabinets at the Royal Adelaide Hospital, and merged with the online responses securely hosted on secure servers provided by eResearch SA. A response rate of 36.5% yielded 197 responses. 133 (67%) of responding practitioners reported having discussed this practice with their patients, and 105 (53%) practitioners reported having cared for a patient following overseas transplant. A total of 129 patients were reported between the years 1980 and 2018 and the transplants were performed in 17 different countries, with China (n=40, 31.2%), India (n=20, 15.6%), Pakistan (n=11, 8.6%), and the Philippines (n=10, 7.8%) being the most popular destinations. 34% of patients traveled to their country of origin for the transplantation, as is demonstrated by Figure 1. Significant numbers of patients returned with infective complications (25.6%, n=33) with a comparatively low rate of rejection reported in those returning (7.8%, n=10). In terms of comparison with ANZDATA, manual comparison yielded 42 total cases from the Overseas Transplant Survey (OTS) which were ‘missing’ from ANZDATA, discounting seven non-renal cases. The distribution is demonstrated in Figure 2, with 40% (n=17) occurring between 2015 and 2018. This is supported by Figure 3, which demonstrates a downward trend in ANZDATA whilst OTS indicates a recent uptrend for overseas transplantation. The results provide valuable insight into the demographics most likely to participate in the practice, allowing for targeted approach to educate patients. Additionally, the discrepancy between the OTS and ANZDATA information on the practice provides a case for proposing mandatory reporting legislation to allow for improved data collection regarding the scope, complications and patterns of the practice.