Renal transplantation in Iran over the past two decades: a trend analysis

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.

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.

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%).

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.