Organ transplantation and the need for a new attitude

Numerous field studies indicate an increase in the incidence of chronic non-communicable diseases in our country. About half of people over the age of 50 in our country suffer from high blood pressure. About a quarter of people have some degree of kidney failure. It is estimated that in the next two decades, about one-fifth of our compatriots will develop diabetes. These are just a few examples of the situation of these diseases in our country. Chronic cardiovascular, hepatic and pulmonary diseases are also on the rise. These diseases have several common features; First, controlling these diseases and their complications is associated with high costs for society. Second, these diseases reduce the useful life of people and are associated with physical disabilities and, ultimately, death. These issues will face our country with serious economic, social and even security challenges. Given the limited resources of the country, especially in the current situation, the most important question for health policy makers is to prioritize the allocation of resources; For example, it has recently been suggested that the country needs 2,500 new dialysis machines and 1,000 machines have been purchased. The fact is that with 10% of this amount, one thousand patients with kidney failure can be transplanted. This number is about 40% of kidney transplants in our country at present. People who have had an organ transplant have a longer life expectancy than people undergoing dialysis, have a better quality of life, and have a much lower transplant cost compared to dialysis. It is predicted that the number of people with kidney failure in our country is increasing by about five to 20% annually. This number will be added to the country’s health care system. Due to the fact that a significant number of these patients are under 40 years of age, kidney transplantation is the preferred method of treatment. This requires an increase in the number of kidney transplants in the country. Unfortunately, in many provinces of the country, kidney transplantation is not possible and this makes it difficult for many patients to access this treatment. It is necessary to expand the transplant centers in the country. There are also many problems with chronic liver disease that require transplantation. In our country, about eight thousand patients die every year due to chronic liver diseases (including cirrhosis of the liver), and this number is increasing. It is estimated that our country will need 3,000 liver transplants per year, which is currently only 800 per year. Our country is facing a similar situation in the field of transplants such as heart or lung transplants that need to be planned. Therefore, one of the ways to deal with the phenomenon of increasing chronic non-communicable diseases is to invest in the expansion of transplant services in the country. Of course, educating people in the community to prevent these diseases is also a priority. Fortunately, our country has made great progress in the field of transplantation in recent decades. Using this platform, transplant services should be expanded throughout the country with measured steps; For example, about half of all transplant centers in the country are concentrated in Tehran, and many provinces in the country are deprived of these medical services. In our country, there are very few centers that provide transplant services such as liver, heart or lung that need to be expanded. The expansion of transplant services in our country is currently associated with several challenges that need to be addressed by health policy makers.
Some of these challenges are: 1- Lack of sufficient laws to create a coherent and coordinated transplant system in the country for access to all those in need of these medical services 2- Lack of sufficient information for planning 3- The need to create a culture of transplantation and organ donation 4 Lack of financial and human investment to expand transplant services in the country. Use it optimally. Now that our country is in a full-blown soft war and various issues in the field of providing medicine and equipment in the field of health and treatment are heard every day, it is appropriate to overcome the current problems with wisdom, foresight and proper planning. And provide the future. Short-term and long-term investment and planning in the field of transplantation can be one of the priorities and solutions.

Dr. Reza Saidi Firoozabadi – Transplant Surgeon