Renal allograft procurement from living unrelated donors in Iran: What falls under the eclipse

Abstract

Renal transplantation is the treatment of choice for end stage kidney disease. However, despite all the efforts to expand the donor pool, the shortage of donors is increasing and as a consequence, there has been a significant increase in the number of patients on transplant waiting lists globally. Societies worldwide have employed different methods to address this, each with specific ethical concerns surrounding them. Over three decades ago, a governmentally regulated program of kidney transplantation from living unrelated donors was introduced in Iran and since practiced which has been the subject of hot debate in the literature. Nevertheless, despite all these extensive discussions and publications, several key aspects of the program have still not been properly elucidated and addressed. In this article, the author aims to illuminate some dark corners related to this issue that have largely escaped the notice of ethicists.

Keywords: Allograft procurement; Renal transplantation; Living unrelated donor; Organ market; Iran

Core Tip: Iran's living unrelated kidney transplantation program has several limitations by its definition, but what is already in practice goes far beyond that and is actually a government legislated and regulated kidney market in which the laws and supports all essentially best serve the interests of brokers and financial agencies, and result in exploitation of the poor on either the recipient or donor.