Transplanation History

Iran is a tropical country with a land area of 1,648,000 square kilometers and situated in southwest of Asia with population around 70 million.  Its recorded history dates back to 2553 years ago. Its earliest medical school was in Jondi Chapour University that was founded 1753 years ago during the Sassanid dynasty as a center for higher education in medicine, philosophy, and pharmacology. Indeed, the idea of xenotransplantation dates back to days of Achaemenidae (Achaemenian dynasty), as evidenced by engravings of many mythologic chimeras still present in Persepolis. Avicenna ( 980-1037 AD), the great Iranian physician, performed the first nerve repair.

Transplantation progress in Iran follows roughly the same pattern as that of the rest of the world, with some 10-20 years' delay. Modern organ transplantation dates back to 1935, when the first cornea transplant was performed at Farabi Hospital in Tehran, Iran. The first living-related kidney transplantation performed at Shiraz University Hospital dates back to 1968. The first bone marrow transplant was performed in Dr. Shariaati's Hospital of Tehran. The first heart transplant was performed 1993 in Iran. The first liver transplant was performed in 1993 in Shiraz. The first lung transplant was performed in 2001, and the first heart and lung transplants were performed in 2002, both in Tehran. In late of 1985, the renal transplantation program was officially started in a major university hospital in Tehran and was poised to carry out 2 to 4 transplantations each week. Soon, another large centers initiated a similar program. All of these centers started  training education of surgical, medical, and nursing teams from other academic medical centers in kidney transplantation. Since 2002, Iran has grown to include 23 active renal, 68 cornea, 2 liver, 4 heart, 2 lung, and 2 bone marrow transplantation centers in different cities Tehran & Shiraz.

In June 2000, the Organ Transplantation Brain Death Act was approved by the Parliament, followed by the establishment of the Iranian Network for Transplantation Organ Procurement (Iran TOP). This act helped to expand heart, lung, and liver transplantation programs.

 

Organ Transplantation in Iran

Organ transplantation is a life saving treatment in patients who suffering from advance organ failure and improves patient's quality of life.  Transplantation in some organ is the only alterative treatment and in the others organ like kidney is the best way. Among other therapeutic modalities from you point of effectiveness and the cost.

The first kidney transplantation in Iran was performed in shiraz ( Namazee hospital) in 1968 by saldizadeh. All of the transplanted kidneys in Iran before revolution (1979) where about 80 cases and the donor's kidney transported to Iran form the abroad. After revolution the first living donor kidney transplantation was performed by Fazel.I in Tehran in 1985.

Kidney's transplant wards and training centers growths dramatically, in Iran and now in the country 25 centers of kidney's transplantation is active and each year about 1600 kidneys transplant is perform. The largest kidney transplant center starts their activity after revolution during the Iraq - Iran war while the Iran was under the sanctions and supplying the dialysis devices with commercial limitation was very difficult, and during this time there was no rule for transplantation form the cadaver and supplying the kidney form the abroad was impossible,  hence the living donor kidney transplantation was unavoidable and this program was the only solution of the problem. Prohibition of transplantation of the foreigner from Iranian live donor, paying the government to the donors and physicians, limitation protocol for donation of living unrelated donors by scientific associations is the characteristic of the Iranian model. The process of donation is organized by kidney disease support foundation which is an nongovernmental organization (NGO).  By August 2008, in Iran has performed 504 liver, 159 heart, 23 lung, 2378 bone marrow, 33,638 cornea, and 23,270 kidney transplantations. 82%; Sources of these donations were living-unrelated donor, cadaver, 10%; and living-related donor, 8%. The 3-year renal transplant patient survival rate was 92.9%, and the 40-month graft survival rate was 85.9%. The transplantation program is curently getting expanded through the construction of the Avi-Cenna (Abou Ali Sina) Transplant Hospital in Shiraz. 

 

Statistics on Transplantation in Iran

Kidney

First kidney transplant 1968   
Kidney transplant program 1985
Transplanted up to July, 2008 23270 cases              

 

 Heart

Heart transplantation program 1993
Transplanted heart up to July, 2008 159 cases                          

 

Lung

Lung transplantation program 2000 
Transplanted lungs up to July, 2008 23 cases                             

 

Liver

Liver transplantation program 1993
Transplanted Liver up to July, 2008 500 cases in Shiraz center

 

Bone Marrow

Liver transplantation program 1991
Transplanted Liver up to July, 2008 2378 cases                        

 

Cornea

Liver transplantation program 1935
Transplanted Liver up to July, 2008 33638 cases                      

 

Transplantation from deceased donor source increase gradually

2000 32 cases
2001 70 cases
2002 96 cases
2003 167 cases
2004 207 cases
2005 209 cases
2006 243 cases
2007 311 cases
2008 32 cases

 

Transplantation of different organs in last 2 years

Organ 2006 2007
Kidney 1615 1600
Liver 99 130
Heart 18 37
Lung 7 3
Bone Marrow 430 480
Cornea 4621 480

 

15 Transplantation centers in Iran according to number of Transplantation

kidney

Shaheed Labafi nejad  Hospital  Tehran
Shaheed Hashemi nejad Hospital  Tehran
Baghiatollah Hospital  Tehran
Emam Khomeini Hospital  Orumieh
Nemai Hospital   Shiraz
Shariati Hospital  Tehran
Mehrab Hospital   Kermanshah
Sina Hospital    Tehran
Emam reza Hospital     Mashhad
Taleghani Hospital Tehran
Nour & Ali Asghar Hospital  Isfahan
Modarres Hospital   Tehran
Qaem Hospital   Mashhad
Golestan Hospital  Ahvaz
Emam Khomeini Hospital    Tabriz

     

Liver transplant centers

Namazi Hospital  Shiraz
Emam Khomeini Hospital    Tehran

 

Heart & Heart Lung transplantation

Shariati Hospital Hospital  Tehran
Emam Khomeini Hospital    Tehran

                               

Born Marrow transplantation

Shariat Hospital    Tehran
Namazi Hospital Shiraz

 

Shiraz, cultural capital of Iran, is one active centers organ transplant in Iran and Middle East.  Shiraz is pioneer of solid organ transplant in Iran so that the first renal, liver, heart and pancreas transplantation have been performed in Shiraz. The first renal transplant was done in 1967 (by Dr Sanadizadeh). After Islamic revolution, organ transplant was completely banned for a few years. In 1985 this practice resumed and Shiraz was one of the first medical centers that began doing organ transplantation.

Shiraz organ transplantation unit started to work at 1988 and the first renal Tx. was performed in 1988 at this center.  The first liver transplantation of Iran was performed in 1993 in Shiraz by Dr. Malekhosseini and coworkers and  up to now this center is only center in Iran that doing liver transplantation routinely.

The first successful heart transplantation of Iran was also performed in Shiraz by Dr Sanjarian and his colleague in ………….

The first pancreas program transplantation in Iran was done in Shiraz, Nemazi Hospital.

By 2006: a total 1886 Renal transplantation, 25% cadaver, 31% living related and 44% unrelated  liver Tx500 , Pancreas 45 , was done in Shiraz transplantation unit. 

 

Shiraz Transplant Center

Shiraz transplant center started activity with kidney transplantation in 1988 during first years most patients transplanted with living unrelated but first consent from a diseased donor gained 1992 and then transplantation from diseased donors increase gradually. In 1999 the south of Iran network was established and consent from the deceases increased dramatically (south network of Iran for donation page?)

 

South of Iran network for donation

First kidney transplantation program started in Shiraz in 1988 when national organization for organ procurement Iran Top has not been founded yet. Fatawa of Shiite clergies for use of deceased donor announced in 1989. Based of this fatawa Shiraz center started to obtain the consent for harvesting organs. From 1988 until 1991 the program continued only by living donor. In 1992 the first consent was gained from a deceased donor family in Shiraz. During 1992 – 1993 six consent was obtained. Liver transplant program also started in 1993. for increase the donation we began educated and informing the ICU, emergencies and neurosurgical wards nurses, neurologist, neurosurgeon and anesthetist in our province (Fars) and seven provinces in south of Iran . the necessity, diagnosis, confirmation and reporting of deceased donor discussed  and this program repeated every six months. From 1992-1998 only 21 of 128 family  of deceased donors (16.4%) were allowed to harvest the organ. In 1998 seven transplant coordinators and nurses and 100 staff (personnel of surgery and neurosurgical ICU, emergencies department  nurses wards) sixty nurses, surgeon, anesthetist, neurologist working in 20 cities. After this seminars 7 consents in 1998, 21 consents in 1992 and 243 from 2005 (each year 40 consents) were obtained. 2/3 of consents of deceased donor was from the Fars and seven provinces in south of Iran.

 

Iran TOP (Iranian network for Transplant Organ Procurement)

The first brain dead law approved in the Iranian parliament in 2000 and then brain death protocol approved in 2002 by ministry of Health. Iran TOP founded in 2002 in Tehran and its branches in other provinces of Iran in 2003 in all country universities brain death diagnosis and approval team was established.  Deceased approval is done only in universities hospitals. The current status of reporting, diagnosis and harvesting of deceased donor as below.

 

Kidney transplantation in Iran and Shiraz

The first kidney transplantation was performed in Shiraz in 1968 but after that program not continued. The first program o kidney transplantation started in Shiraz in 1988. During first years the kidney transplantation performed only living donation and the first kidney from the deceased donor in 1992 and then transplantation from the deceased donor increased gratefully up to March 2008. 1839 cases of kidney transplant performed in Shiraz Transplant about in Iran about 10% of transplant kidney is from the in Shiraz is about 25% is this due to activity of south netork of Iran center.

Living related 789
Living no related  592
Deceased donor  458

 

Deceased donor is 25% of transplantation kidney and living non related is about 32% of Transplant Center  in Iran because of we insist to transplant kidney fromdeceased and related. 

 

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