Iranian experience with the non-related renal transplantation

Abstract

Kidney transplantation is the treatment of choice for most uremic patients. However, organ shortage remains the central problem in kidney transplantation. To deal with the widening gap between supply and demand of organs for renal transplantation, efforts to expand the organ donor pool have received increased attention. To solve this problem, we have initiated a living unrelated donor (LURD) program using emotionally related persons, friends and well-motivated volunteers as organ donors. A controlled transplant program, now known as the "Iran model", supported by the government for LURD renal transplantation was launched, which resulted in eliminating the waiting list. A charity founded by patients with end-stage renal disease, acts as a liaison agency and the altruistic volunteers have to register with the foundation for being introduced to the potential recipient referred by transplant centers. This review deals with the history of renal transplantation in Iran and describes the "Iran model" protocol and our experience of the non-related renal transplantation. Our results indicate that proper selection and pre-operative management of potential living donors lead to promising results in kidney transplantation. The health of the living donors is not impaired by the donation. The rate of early post-operative complications is low. Living donor kidney transplantation, in our geographical area with a low-rate of cadaveric donor transplants, is an alternative to expand the donor pool, yielding better results in terms of patient and graft survival.