Renal transplantation in Iran

Iran—formerly called Persia—is located in the Middle East between the Caspian Sea and the Persian Gulf. It covers 1 648 000 km and has 60 million inhabitants. The prevalence of end-stage renal disease (ESRD) patients in Iran is about 15 000 and the annual incidence of new ESRD patients is 3175 or 53 patients per million populations per year. Iran has the most successful renal transplant programme in the region. The renal transplant activity of the country has reached 24 renal transplants per million per year. There are two periods in the evolution of the renal transplantation programme in Iran. During the first period (1967–1988) all transplants were from living related donors (LRD) and the number of renal transplants performed was much lower than the national demand. In the beginning of the second period (1988–2000) by careful attention to the country’s cultural, religious, and socioeconomic backgrounds a controlled living unrelated donor (LURD) renal transplant programme was adopted. As a result, in the last 12 years more than 10 000 renal transplants were performed and the renal transplant waiting list was eliminated by the end of 1999. In this article, I will first review the history of renal transplantation in Iran from 1967 to 2000 and describe the practice of renal transplantation emphasizing the characteristics of our LURD renal transplantation programme. Then I will report the results of 1420 consecutive renal transplants from LRD and LURD that have been carried out in our centre. Finally, I will discuss the necessity for and the ethical issues involved with our LURD renal transplantation programme. History of renal transplantation in Iran (1967–2000)