Kidneys on demandBMJ 2007; 334 doi: http://dx.doi.org/10.1136/bmj.39141.493148.94 (Published 08 March 2007) Cite this as: BMJ 2007;334:502
- Anne Griffin, Clegg scholar
When a Toronto based transplant surgeon and bioethicist wrote last year that Iran had eliminated its waiting list for kidneys, the lay press listened. Abdullah Daar made the claim in NatureClinical Practice Nephrology while arguing for a regulated system of living kidney sales.1 An approving editorial in the Economist shortly after declared: “Governments should let people trade kidneys, not convict them for it.”2
But not everyone agrees that the claim is true. “It depends on how you define waiting list,” Behrooz Broumand, a past president of the Iranian Society of Nephrology, told the BMJ. Javaad
Zargooshi, a urologist at the Kermanshah University of Medical Sciences, goes further. “The elimination of the waiting list has never occurred in Iran. It is merely a Goebblesian lie repeated over and over by the commercial programme's spin doctors,” he said.
Dr Daar backs his claim with a reference to a paper by Ahad Ghods.3 For data on Iranian transplants Dr Ghods's paper references only his own work for Iranian data, and the original source is unclear: The results of a large academic hospital in Iran are given “as an example for the whole country.”4 So what is the truth about transplantation in Iran?
After the 1979 Iranian revolution, materials for dialysis were in short supply and there was no system of cadaveric donation. If you lost kidney function, you either went abroad for transplantation or died in Iran. The Ministry of Health set up two renal transplantation teams in the mid-1980s, the first of which was headed by Iraj Fazel, a surgeon who trained in the US and subsequently became minister of health and medical education.