Kidneys on demand

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?