Development of a kidney transplantation program--inverted funnel approach

Area of Science:

• Medical Science
• Transplant Surgery
• Public Health Policy

Background:

• Organ shortage is a global challenge with diverse national approaches.
• Iran's organ transplantation history offers a unique case study.
• This review examines Iran's inverted funnel approach to organ procurement.

Purpose of the Study:

• To analyze Iran's historical progression in organ transplantation.
• To elucidate the roles of government, professionals, and the public in organ donation.
• To understand the impact of policy and public engagement on organ availability.

Main Methods:

• Historical review of Iran's transplant program over two decades.
• Analysis of three distinct phases: living unrelated donation, brain death donation legislation, and implementation.
• Examination of sector-specific contributions (government, professionals, public).

Main Results:

• Kidney transplants from brain dead donors (BDDs) significantly increased from 0.4 pmp in 2000 to 15.1 pmp in 2013.
• Transplants from living donors showed a relative decrease during the same period.
• This shift indicates a growing reliance on deceased donor organs.

Conclusions:

• Governmental support for organ procurement from BDDs is crucial, driven by economic benefits and legislative backing.
• Professional engagement in public awareness, protocol adaptation, and training is vital.
• Public acceptance and participation are key to overcoming organ shortage through deceased donation.