Studies have shown a correlation between organ transplant (Tx) activity and human development index (HDI). Iran is a country with high HDI and its organ donation & Tx activity specially from deceased-donors is steadily increasing. The first renal Tx was carried out in Iran in 1967, which was also the first organ Tx in current MESOT counties. From 1967 to 1985, only approximately 100 renal Txs were performed. Twelve of these 100 kidneys came from Euro-transplant that were transplanted prior to 1979. Between 1979 and 1985, more than 400 patients travelled abroad and received a renal Tx using governmental funds. In 1985, the high expenses of renal Tx abroad prompted health authorities to increase renal Tx activity inside the country. Two renal Tx teams were organized, and between 1985 and 1987, only 274 renal Txs from living related donors were performed. In 1988, because of a long renal Tx waiting list at the Ministry of Health for Tx in abroad, a regulated living unrelated donor renal Tx program was adopted. As a result, the number of Tx teams and the number of Txs that were performed increased rapidly such that by 1999, the renal Tx waiting list was eliminated. In 1989 a religious decree from supreme religious leader was obtained recognizing the concept of brain death and allowing deceased donor organ Tx. This was followed by performing a number of deceased donor kidney Txs. In 1982 the first liver Tx was performed by Dr. Malek Hosseini in Shiraz. In 2000, the legislation of Organ Trans¬plantation and Brain Death Act legalized organ donation from deceased donors. This was also followed by establishing Organ Procurement Centers and Brain Death Identifica¬tion units all over the country. At first, Organ Tx Center in Shiraz University started performing increasing number of deceased donor kidney, liver and pancreas Txs and remained a successful deceased donor organ Tx model in the country. Then other Tx centers increased their deceased donor organ Tx activities.

By the end of 2012, a total of 34,166 kidney Txs (4,436 from deceased donors ),2021 liver Txs (1788 from deceased donors),147 pancreas Txs, 482 heart Txs, 63 lung Txs, several intestine Txs have been performed . Since2000, the annual number of deceased donor kidney, liver, heart, lung and pancreas Txs has increased steadily in the country. In 2000, only 2.2% of all renal Txs were from deceased donors. This increased to 10%, 20% and 38% by the years 2003, 2008 and 2012 respectively. In 2011, Iran by performing 2771 solid organ Txs(37pmp) ranked 33rd between 50 most active countries globally and 2nd after Turkey between MESOT countries. But in donation and Tx from deceased donors Iran was ahead of all MESOT countries including Turkey, Kuwait and Saudi Arabia. In 1012, a total of 3002(39.2pmp) solid organ Txs were performed . Again Iran was the 2nd after Turkey in all solid organ Tx activity but ahead of all MESOT countries in deceased donor organ Tx.