Everything About Kidney Transplantation in Iran

Kidney transplantation is the most promising and last treatment option for kidney patients. Kidney transplantation, in addition to it being a more cost-effective method than dialysis sessions, will improve the quality of life of kidney patients. But the biggest challenge of kidney transplantation in Iran is related to the supply and demand of kidneys. Kidney donors are divided into related and unrelated. Related donors are those who are related to the recipient and unrelated people who have no relationship with the recipient. Unrelated donors donate their kidneys for a variety of purposes, one for altruism and benevolence, and the other for commercial aims. In developed countries, half of the kidney transplants are received from living people, while living donors are more at greater risk of surgical complications, physical and mental problems, and even a risk of death. So far, the highest rate of transplants performed in Iran has been from living donors. The results of kidney transplant surgery are more favorable from living donors than from brain-dead donors. Keep reading on Moj Aramesh Amitis Health Tourism Company’s website to learn more about kidney transplantation in Iran.

 

Kidney Receipt Sources for Kidney Transplantation in Iran

The first kidney transplant was performed in Iran in 1967 in Shiraz. Kidneys are received from three main sources, including the following:

1. Related kidneys (received from relatives)
2. Unrelated (with financial or altruistic interests)
3. Donation from a deceased donor

If kidney transplantation is successful, the patient’s need for dialysis sessions will be resolved and as a result, the patient’s quality of life will be improved. Kidneys donated through deceased donors are deficient, and people who receive kidneys in this way must wait a long time. Therefore, the focus of the medical community has shifted to living donors. The lack of organs for kidney transplantation is still a major problem globally and several countries are using different methods to address and solve this problem. The problem of organ shortage in Iran is largely solved with the help of charities and the active role of the government in this regard. Following the high demand for kidney donors, the black market of speculators for organ trading has been formed. Receiving kidneys this way will be available only to those people who do not have financial problems. The Iranian government plays an important role in assisting economically weak recipients by allocating a portion of the budget to purchase all unrelated donors.

The Iranian Model of Kidney Transplantation

Kidney transplantation is on the rise worldwide with the incidence and prevalence of kidney failure leading to advanced kidney disease. In this article from Moj Aramesh Amitis Health Tourism Company, we investigate the model of kidney transplantation in Iran in the last 5 years. In this study, the status of kidney transplant patients in one of the hospitals in northern Iran was evaluated and the obtained data related to age, sex, location, source of the donated kidney (living, deceased, unrelated, related), method of receiving kidney (donated, purchased) and the waiting time for a kidney transplant. A total of 228 patients were evaluated, of which 73.7% were male and 3.26% were female. The average waiting time for a kidney transplant in northern Iran was 386 days and the average age of patients on the waiting list was 7 to 32 years. The highest number of kidney transplant donors was through unrelated living people and about 66% and the lowest number of transplant donors was through deceased people and about 14%. These cases show that there has been no progress in receiving transplants from deceased donors, and despite kidney transplant technology in Iran, most of the transplanted kidneys have been purchased. Also, the statistics of purchased kidneys were 51.8%. In general, the number of living donors in Iran is about 1,615 annually. Also, according to the statistics obtained between 2006 and 2014, about 3,736 kidney transplants were performed in Iran. Kidney transplant surgery through an alive donor has much better results. For this reason, kidney donations from deceased people are less popular among kidney recipients. Due to cultural and religious factors, Asian countries such as Iran are new in this field. This led to the first kidney transplant from a deceased donor in Iran 16 years after the first kidney transplant. Choosing the gender of deceased donors for kidney transplants is still a trouble. However, the number of deceased kidney donors has increased compared to previous years in Iran.

Kidney Transplantation Procedure in Iran

If the recipient chooses a kidney transplant from an unrelated donor, he or she will be referred to the Kidney Patients Foundation, and any 18-35-year-old person who intends to receive or donate a kidney will be referred to the Kidney Patients and Dialysis Association for registration and the rest of the kidney transplant procedure. The process of donating a kidney and receiving it in this foundation is free for recipients.

1. First, the donor and recipient must perform the necessary tests and imaging in the clinics of the kidney foundation. Informed consent from kidney donors and close relatives must then be submitted to the Foundation along with an ID card.

1. Then, the donor and recipient of the kidney are introduced to each other and referred to a nephrologist for a final examination of their condition. If the donor has borderline laboratory information, he/she cannot donate his / her kidney.

1. In the third stage, a final negotiation will be held between the donor and the recipient to discuss the additional fee received by the donor. However, this negotiation takes place at the Kidney Patients Foundation. However, the Foundation does not play a role in this process and does not register the discussed fee. If an unreasonable amount is offered to the recipient by the donor, another donor will be introduced to the recipient by the Kidney Foundation. After kidney transplant surgery, the donor submits the transplant documents to a charity and receives a gift of altruism plus a year of free NHS.

Kidney Transplantation Waiting List in Iran

Most kidney transplant surgeries in Iran have been performed through living donors. In 1988, kidney transplants from unrelated donors were approved in Iran, resulting in a rapid increase in the number of kidney transplant centers and kidney transplant surgeries in Iran, so that in 1999 the waiting list for kidney transplants in Iran was removed and until 2005, about 19,609 kidney transplants were performed. In the last five years, the waiting time for kidney transplantation in Iran has decreased. Some factors such as gender, low age, and living in urban areas are effective in shortening transplantation waiting time. According to statistics, people with such conditions spend less time on the waiting list. Currently, about 50 percent of kidney patients in Iran live with transplanted kidneys. In recent years, the number of kidney transplant surgeries in Iran has increased, about 2,500 to 2,700 transplants are performed annually in Iran.

Factors Affecting Kidney Transplantation Waiting List in Iran

The chance of a kidney transplant increases with age. Also, the average waiting time for women is significantly shorter than for men. When kidney donors are unrelated to the recipient, recipients wait about 178 days shorter than the rest of the waiting list. If the donors are relative to the kidney recipients, the waiting time for a kidney transplant is about 38 days less than the rest of the recipients on the waiting list, and if the kidney is purchased, the waiting time for a kidney transplant is about 170 days less than the rest. In addition, living in rural areas has increased the waiting time for a kidney transplant. As a result, people in the village are about 22 percent more likely to be on the waiting list.

Concluding Remarks

Organ transplantation is one of the most important issues in the medical community. Due to the increasing number of kidney transplants in Iran and as a result of scientific advances in this field, religious scholars have paid special attention to this issue. While other developed countries such as Japan still have many cultural problems in accepting this issue. The truth is that donors cannot continue to live like normal people after donating their kidneys. Therefore, kidney recipients are reluctant to receive kidneys from close relatives. In addition, kidney donation through unrelated individuals is often done for economic reasons. As a result, well-off patients are more likely to receive a kidney transplant.

 

 

Author: Sh. Khazaei

Translator: N. Rahimifar