Kidney Transplant Program in Iran

Recent Advances in Renal Transplantation meeting was first in the Kingdom of Saudi Arabia. It did not offer much in terms of clinical information compared to Ahmedabad meeting but the fact that it allowed discussion on cadaver and live donor transplant under ethical and religious lines was itself encouraging. Another sign of changing times?

Nearly 600 Saudi patients underwent kidney transplant but nearly 2/3rd of them did so outside the country. Bulk of them did from Pakistan and Egypt.

What impressed me most was to know about Renal Transplant protocol in Iran. Despite being large size country with 70 Million population. they do not have any patient waiting for kidney transplant; something that even developed country has not achieved it. They have most successful transplant program that has alleviated sufferings of renal failure patients in Iran is indeed thought provoking. Their success is now termed as ‘Iranian Model’ and is cited in major journals.

Few of the salient points of Iranian model are:

Iran has exclusive Govt Department CDI. Central Dialysis Institute. They assign every renal patient to nearby hospital. They also monitor purchase needs of the country in terms of machines and consumables.

Regarding Kidney transplant procedures, Dialysis and Transplant Patient Association (DATPA) committee, which is made up of patients, assesses the donor .

All renal transplant surgeries are carried out only in Government Hospital and no private hospital has any role. All expenses towards surgery, laboratory test, drugs are free of charge.
Government does not distinguish between kidney donors who are related or non related to the recipients. In fact, they seem more generous to unrelated Kidney donors. Those who volunteer to donate the kidney to unrelated recipient; government gives him cash compensation equivalent of 6 months of his salary, lifetime health insurance, plus recognition award. It is for this reason; nearly 78% of Kidney is donated from unrelated patients. Surprisingly they do not offer any cash compensation to donor who is related. According to them, related donors do it for emotional reasons

in 2004, 1,904 Kidney transplants were carried out They have done nearly 204 cadaver transplants and they hope this number would go up.

No foreigner is allowed to have transplant with Kidney from Iranian.

Govt maintains database of donors in terms of age group, economic status. 84% of Poor economic class donors have given Kidney to 50% Poor economic class recipients. 16% donors from middle class donated to 34% recipients from middle class. While none from affluent, economy class has donated Kidney while 16% of affluent economy class has been recipients from poor and middle class. They do keep a close watch on migration of Kidney from poor people to others economic strata of the society.

They are particularly keen hat Afghan (half million) and Iraqi refugees (2.5 million) do not get have ever end up giving Kidney to Iranians.

Iran offers lifelong free Hemodialysis treatment to all its citizens with quality standard that of best in the world. All the necessary consumables are assembled in Iran thereby reducing purchase price. With the above transplant program, now people wean away from Hemodialysis thereby saving Iran Govt the necessary resources.