Renal Transplantation in Iran Over the Past Two Decades: A Trend Analysis

doi:10.1016/j.transproceed.2007.03.094

Transplantation Proceedings

Volume 39, Issue 4, May 2007, Pages 923-926

https://doi.org/10.1016/j.transproceed.2007.03.094 Get rights and content

Abstract

Background

In this study, we have reported updated statistics of the Iranian Transplantation Registry, the status of the recipients and grafts, and a detailed time trend with respect to patient characteristics.

Methods

We retrospectively reviewed the Iranian Renal Transplantation Registry and information from the Dialysis and Transplant Patients Public Association, to obtain data on all kidney transplantations performed in Iran between 1986 and 2005. Data were gathered regarding the total number of transplantations, graft loss, recipient death, and donor and recipient characteristics, including demographic data, cause of end-stage renal disease (ESRD), and source of kidney. We assessed changes in variables on a biannual basis.

Results

A total of 19521 transplantations were registered over the study period, of which, 761 recipients (3.9%) had died and 2333 allografts (11.9%) had been lost. The source of the kidney in 2556 (13%) subjects was a living related donor (LRD), in 16234 (83%) a living unrelated donor (LURD), and in 831 (4%) cadaveric. During the study decades we noted an increase in the number of kidney transplantations (from 22 to 3690), age of recipients (from 30 to 40), male-to-female ratio of recipients (from 0.58 to 0.67), male-to-female ratio of donors (from 0.48 to 0.52), diabetes mellitus (from 0% to 27%), and hypertension (from 4% to 15%), as causes of ESRD, as well as the use of cadaveric kidneys (0% to 11%).

Conclusion

Analyzing renal transplantation data not only helps to evaluate the effectiveness of transplantation activities in a country, but also provides information to estimate future costs in the health care system.

Section snippets

Materials and Methods

In a retrospective study, we reviewed the Iranian renal transplantation registry data of all renal transplant patients in Iran between 1986 and 2005. We extracted data from Dialysis and Transplant Patients Public Association. We recorded data of kidney donors and recipients, including age, sex, donor type, and cause of ESRD such as diabetes and hypertension. Hospital-based data on the number of annual transplantations, rejection, and death were also collected.

Data were analyzed using SPSS

Results

The 19,521 kidney recipients and donors, showed a mean age of 38.5 years (range, 30 to 40 years) and 28.86 years (range, 27 to 38 years), respectively. The source of the kidney was living related donor in 2556 (13%) cases, living unrelated donor (LURD) in 16,234 (83%), and cadaveric in 831 (4%). Among recipients, 12,063 (61.8%) were men and 7458 (38.2%), women.

Of all patients, 761 recipients (3.9%) died and 2333 allografts (11.9%) were lost. During the study decades, we noted an increase in the

Discussion

According to the statistics presented here, at the start of 2006, among 19,521 kidney recipients, 16,427 subjects with functioning grafts were receiving health care services in Iran. The transplantation rate in our country shows an increasing trend, in line with the developments in transplantation, with some changes in demographic and clinical variables trending toward a higher age and a larger number of patients with complex causes of ESRD, such as diabetes mellitus and hypertension. We also

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End-Stage Renal Disease in the Middle East
2017, Chronic Kidney Disease in Disadvantaged Populations
Chronic kidney disease (CKD) imposes great burden on health budgets in the Middle East. The incidence of CKD is inadequately studied and reported, while the incidence of end-stage renal disease (ESRD) in the Middle East countries is around 110–140 cases PMP. The current data about prevalence are mainly of treated ESRD. There is a paucity of published population-based studies and registries for incidence and prevalence of CKD and ESRD in most of the Middle East countries. This reflects adversely on the health planning for effective preventive and therapeutic measures in the region. There is a high variability of prevalence of renal replacement therapy in the different countries in the Middle East. The available services have variable standards in the Middle East countries and inadequate measurement of outcome. The political unrest and the inadequately allocated budgets for research, planning, and services in the Middle East countries affect negatively the care for the CKD patients. To surmount the obstacles facing the renal services in the Middle East countries, there should be an expansion of the health expenditure, which is still not a priority for national budgets. Dissemination of health education on the advances of therapeutic and preventive medicine for kidney diseases should be also practiced extensively in the countries of the Middle East.
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Paying for kidney or other organ donation has lead to heated debates about donor and recipient welfare. Many have argued that paying for donation leads to coercion and exploitation of the poor, and, in the end, produces more harm than good. Others have said that payment helps the poor, and we should all have sovereignty over our bodies and, thus, should be allowed to donate for remuneration. Although World Health Organizations and governments in many countries have now banned the process of paying for donation, there is still ongoing payment legally and illegally. Thus, this timely set of three articles from Iran, Pakistan, and the Philippines, where paid donation has been extensively performed, will allow the reader to decide for themselves whether the benefits and/or harms of this practice are now clear.
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: This study was fully supported and funded by Baqiyatallah Medical Sciences University.

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Renal transplantationOutcomeRenal Transplantation in Iran Over the Past Two Decades: A Trend Analysis

Abstract

Background

Methods

Results

Conclusion

Section snippets

Materials and Methods

Results

Discussion

Am J Kidney Dis

Transplant Proc

Public Health

Transplant Proc

Transplant Proc

Transplant Proc

Transplant Proc

Am J Kidney Dis

Middle East Society for Organ Transplantation (MESOT) Transplant Registry

Exp Clin Transplant

Worldwide networking: TPM international registry of organ donation and transplantation (IRODAT) MESOT 2004

Exp Clin Transplant

Trends in mortality and graft failure for renal transplant patients

CMAJ

Determinants of long-term survival of adult kidney transplants: a 1999 UNOS update

Clin Transplant

Prediction of 3-yr cadaveric graft survival based on pre-transplant variables in a large national dataset

Clin Transplant

Prognosis after primary renal transplant failure and the beneficial effects of repeat transplantation: multivariate analyses from the United States Renal Data System

Transplantation

The impact of body mass index on renal transplant outcomes: a significant independent risk factor for graft failure and patient death

Transplantation

Renal transplantation
Outcome
Renal Transplantation in Iran Over the Past Two Decades: A Trend Analysis