Familiarity with the challenges of organ transplantation in Iran The need for development and cooperation

Organ transplantation is a new field in the world and in Iran. In our country, in the last few decades, good progress has been made in this field, including organ donation from a living person and a corpse, and the establishment of numerous transplant centers, especially kidney transplants, but it also faces its own challenges.

The high prevalence of chronic diseases such as hypertension, diabetes, obesity and kidney disease will greatly increase the need for transplantation in the coming years, so it is necessary to prepare for the future with coherent and purposeful planning in this area.

Many chronic diseases eventually lead to organ failure such as kidney, liver, heart, etc., which results in nothing but physical disability or death.

Organ transplantation is the best treatment to prevent these complications.

In order for organ transplantation in Iran to be able to face this workload in the future, it faces several challenges, some of which I will mention below and its potential solutions:

1- Lack of a coherent link system

In our country, there are several transplant centers, especially in the field of kidney transplantation, but each of these centers operates independently of the other and there is no integrated and coherent system for organizing and evaluating their activities. This has led to insufficient and accurate information on the link and its orientation in the future.

This situation will make it difficult to assess current problems and plan to improve quantity and quality in the future. It is necessary that all transplant centers be covered by a coherent system.

This will help to integrate the transplant, improve the quality and quantity of services provided, and improve patients’ access to transplant services.

2- Lack of national transplant laws

One of the reasons for the lack of a coherent link system in our country is the lack of national laws in this field. The only law in this area only mentions the use of organs from brain dead patients for transplantation. Although this was a great move for the initial development of the transplant, it will not be a sufficient solution in the future.

Our country needs coherent laws for the policy of organ donation and its development, increasing the quantity and quality of transplants, patients’ access to this service, especially the necessary insurance coverage for patients.

3- Lack of national database in the field of organ donation and transplantation

One of the necessities and tools of planning for the future is to have sufficient and accurate information. Due to the lack of national cohesion in the field of transplantation, unfortunately, our country lacks this information. Although various centers have information about their performance and results, but at the national level, our country lacks this data.

With the enactment of national laws, transplant centers are required to provide information about their transplant activities and their results to the national database. Using this information, problems can be found and action can be taken to solve problems and improve the quantity and quality of transplant services.

4- The need for culture building and development of organ donation at the national level

Although organ donation in our country has been accompanied by great progress, but this has not been the same in all parts of the country. For example, although organ donation has been accompanied by good progress in recent years, but the satisfaction of family members in this area is still very low in some provinces of the country and due to lack of information and national system, transplantation of patients in need Some provinces have problems with brain-dead donors.

Creating a culture for organ donation and creating a national transplant system can ensure that all individuals have access to transplant services nationwide.

5- Lack of equipped centers in all areas of transplantation

Although there are several kidney transplant centers in our country, there are limited equipped centers for transplantation of other members, and this has made it difficult for patients in need of access to transplant services. The number of centers equipped for liver, kidney, heart and lung transplantation is very limited.

It is necessary that at least at the provincial level there are equipped centers that are able to provide all transplant services. Of course, the necessary condition for this is to have a national connection system, sufficient financial resources and experienced manpower. The development of these centers and the cooperation, not the competition between them, will help increase the quantity and quality of transplants in our country.

6- Lack of planning to train a sufficient number of skilled manpower

Developing a transplant to deal with the increasing need of patients for this health service requires the training of sufficient human resources in various fields, especially physicians, nurses, social workers, etc.

Unfortunately, there is no necessary planning and infrastructure in this field. The development of links and the establishment of numerous equipped centers require the careful planning of health supply policymakers to ensure the future of the field.

7- Adequate financial resources and insurance coverage

Organ transplantation is a costly task in health systems. But it has been shown that investing in this field is much cheaper and more cost-effective for the community than treating patients with organ failure.

For example, the cost of a kidney transplant and subsequent care is far less than the cost of dialysis. In addition, the life expectancy and quality of life of these transplant patients is far better than non-transplant patients.

Our country has limited financial resources, so it is necessary for health policy makers to prioritize organ transplants in this regard. This is necessary not only for kidney transplantation but also for post-transplant care for organ preservation. For example, one of the requirements for organ transplant retention is access to transplant drugs.

Therefore, it is necessary to provide adequate insurance coverage for patients’ easy access to these drugs.

Dr. Reza Saidi Firoozabadi – Transplant surgeon