The Iranian model of living renal transplantation

Serological and molecular survey of toxoplasmosis in renal transplant recipients and hemodialysis patients in Kashan and Qom regions, central Iran

“…26,27 While the first case of renal transplantation took place in 1967, the number of transplantation has been dramatically increased until now. [27][28][29] Hence, increase in surveillance and prevention of secondary infections is needed for immunocompromised patients to prevent life threatening outcome. Although different cases of toxoplasmosis have been reported in renal transplant recipients (RTR), [13][14][15][16][17][18][19][20] but few serological and molecular studies of toxoplasmosis have been conducted among RTR and hemodialysis patients.…”

Technology- and Policy-Based Strategies for Increasing Supply of Deceased Donor Livers

“…Controversially, the Iranian government permits the exchange of money between organ recipients and their donor candidates (even providing a "private space" where these negotiations can take place) [36]. There is no limit to the fees proposed by the donor candidate, but if the rate rises too high for the recipient's budget, the Iranian Patients' Kidney Foundation [36] Furthermore, we argue that removing financial barriers (disincentives) to donation is important and should be ethically encouraged. When such barriers are in place, living donation can be financially burdensome, which is ethically unacceptable in the setting of a lifesaving altruistic gift [37].…”

“…Iran provides a stipend to living kidney donors (approximately $400) and one year of free medical insurance [35]. Controversially, the Iranian government permits the exchange of money between organ recipients and their donor candidates (even providing a "private space" where these negotiations can take place) [36]. There is no limit to the fees proposed by the donor candidate, but if the rate rises too high for the recipient's budget, the Iranian Patients' Kidney Foundation [36] Furthermore, we argue that removing financial barriers (disincentives) to donation is important and should be ethically encouraged.…”

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“…8 Iran was essentially trying to provide kidney transplant to her citizens through a controlled LURD program, while expanding deceased-kidney transplant, together with helping the foreign refugees and a few neighboring countries, which had no transplant program and limited dialysis facilities. 10,11,14 However, the policy of "foreign nationality transplant" gradually established a spot where residents of Oman, India, Saudi Arabia, and many other countries, where LURD transplant was illegal, could bring their LURD donors, and be transplanted mainly in private hospitals, to where foreign nationality transplant operations were gradually transferred, with high incentives for the transplant teams. Reports of cases of Omani and Saudi citizens receiving kidneys from Iranian "paid" donors had been previously published and 3 more such cases were recently discovered by Ministry of Health in 2 private hospitals, who had submitted fake Iranian ID cards to receive kidneys form Iranian donors.…”

“…The main debates are the increasing financial relation between the donor and recipient, which could have ideally been eliminated by total governmental compensation instead of a dual recipient-government payment, and the lack of a proper donor follow-up program, with little information about the future of donors. [8][9][10] Foreign nationality transplant in Iran In the Iranian model of kidney transplant, several regulations were adopted to prevent transplant tourism: foreigners were not allowed to receive a kidney from Iranian unrelated or a deceased-donor or donate a kidney to an Iranian patient; however, they could be transplanted from volunteer living related or unrelated donors from their own nationality, after full medical workup, with the authorization of from Ministry of Health. 11,12 This policy helped keep the model within its legally defined framework for many years.…”