Browsing by Author "Ghods, Ahad J."

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Experimental and Clinical Transplantation: A Commitment To Integrity, Accountability, and Ethics in Publication
(Başkent Üniversitesi, 2013-02) Haberal, Mehmet; Shaheen, Faissal A. M.; Rizvi, S. Adibul Hasan; Ghods, Ahad J.; Masri, Marwan
For the past few years, the social, economic, and political issues surrounding the field of organ transplantation have entered into many ethical discussions. Transplant tourism, and organ trade in particular, have finally received the attention they deserve and many commendable developments have ensued. The “Declaration of Istanbul on Organ Trafficking and Transplant Tourism,” the result of a collective effort by hundreds of transplant professionals the world over, is one such example and is now considered the universal charter for ethical conduct in the field of transplantation. The Middle East Society for Organ Transplantation and its official journal Experimental and Clinical Transplantation were among its first endorsers, and it is our policy to ensure that all authors of articles published in our Journal adhere fully to the rules and regulations stated in The Declaration of Istanbul and by the Committee on Publication Ethics. We believe that the medical community must ensure that a foundation of ethical conduct and scientific integrity is maintained throughout the field, and we must strive toward this goal in all our clinical and scholarly efforts.
Governed Financial Incentives as an Alternative to Altruistic Organ Donation
(Başkent Üniversitesi, 2004-12) Ghods, Ahad J.
In 1984, an offensive proposal for kidney sales by a US physician led the National Organ Transplant Act to become a law in the United States. Similar legislation passed in many other countries. An ethical consensus developed around the world that there should be no monetary compensation for transplantable organs, either from living or deceased persons. Unfortunately, the altruistic supply of organs has been much less than adequate, and thousands of patients die each year waiting for organ transplantation. As the altruistic system of organ donation has met with failure, some from the transplant community believe that altruism alone is not enough to satisfy the needs of the thousands of patients on organ transplant waiting lists, and providing some financial incentives or social benefits to organ sources is necessary to increase the number of cadaveric or living organ donations. In this article, the many controversies surrounding altruistic and compensated organ donation systems are discussed. The Iran model for renal transplantation, a compensated and well-regulated living-unrelated donor renal transplantation program that has successfully eliminated a renal transplant waiting list in Iran, is briefly reviewed.
Middle East Society for Organ Transplantation (MESOT) Transplant Registry
(Başkent Üniversitesi, 2004-12) Haberal, Mehmet A.; Shaheen, Faissal A. M.; Stephan, Antoine; Ghods, Ahad J.; Al-Rohani, Muhamed; Mousawi, Mustafa Al; Mohsin, Nabil; Ben, Taieb; Bakr, Adel; Rizvi, Adibul Hasan
During the seventies, sporadic renal transplants were performed in few MESOT-region countries, mainly Turkey, Iran, Egypt, and Lebanon. Since the introduction of cyclosporine in the early eighties, transplantation has become the preferred therapeutic modality for end-stage renal failure. In 1986, the Islamic theologians (Al Aloma) issued what became known as the Amman declaration, in which they accepted brain death and retrieval and transplantation of organs from living and cadaveric donors. Based on this and similar declarations, all Middle Eastern countries except Egypt passed laws that allow cadaveric transplantation and regulate live donations. Iran, Turkey, Saudi Arabia, Kuwait, Tunisia, Jordan, and Lebanon all have current active cadaveric programs and perform liver, heart, pancreas, and lung transplants. More than 5088 renal transplants/year are performed in the region with Iran leading with 1600. The cumulative number of renal transplant patients is now nearly 60,000. With a 2003 population of 600,682,175, the rate/million for renal transplantation in the MESOT region is a mere 9/million. Rates of renal transplantation range from 31/million in some countries to 0 in others. The major obstacle in establishing an accurate number of transplants is “tourist transplantation,” in which the same transplanted patients are registered in different countries. Although cadaveric programs have been active for more than 10 years, live-related and nonrelated transplants account for nearly 85% of the total transplants. The data presented were collected from MESOT representatives in the region and from publications. For proper compilation of the registry, a format is being proposed that will be presented at the Congress for review and adaptation. Even with the limited resources in the region, immunosuppressive drugs for induction and maintenance therapy are available and are used. Costs for transplantation and immunosuppressive therapy are either totally or heavily supported by governmental agencies.
Noncompliance With Immunnosuppressive Medications After Renal Transplantation
(Başkent Üniversitesi, 2003-06) Ghods, Ahad J.; Nasrollahzadeh, Dariush
Noncompliance with immunosuppressive medications in renal transplant recipients results in higher rate of acute rejection episodes, allograft dysfunction, graft loss and patient death. We studied incidence and risk factors of medications noncompliance in 286 renal transplant recipients who were consecutively seen in our renal transplant clinic between February and April 2002. One hundred and seventy were male, 116 female. Their age ranged from 12 to 70 years (mean 39.1 ± 11.6). The length of time since the date of transplantation ranged from 5 to 231 months (mean 76.7 ± 53.5). The results of study showed that 70 patients (24.5%) to be noncompliant (7.7% noncompliant minor and 16.8% noncompliant major). The time since the date of transplanation was a significant risk factor in both noncompliant minor and major groups (P < 0.001 and P < 0.001). The other risk factors associated with major noncompliance was young age (P < 0.001), lower level of education (P < 0.01), lower socioeconomic class (P < 0.05), addiction and psychiatric disorders (P < 0.05). Transplant recipients with major noncompliance also had more acute rejection episodes (P < 0.001) and allograft dysfunction (P < 0.01). We conclude that noncompliance with immunosuppressive medications is very common in renal transplant recipients and it results to significant acute rejection episodes and allograft failure.
Noncompliance With Immunnosuppressive Medications After Renal Transplantation
(Başkent Üniversitesi, 2003-06) Ghods, Ahad J.; Nasrollahzadeh, Dariush
Noncompliance with immunosuppressive medications in renal transplant recipients results in higher rate of acute rejection episodes, allograft dysfunction, graft loss and patient death. We studied incidence and risk factors of medications noncompliance in 286 renal transplant recipients who were consecutively seen in our renal transplant clinic between February and April 2002. One hundred and seventy were male, 116 female. Their age ranged from 12 to 70 years (mean 39.1 ± 11.6). The length of time since the date of transplantation ranged from 5 to 231 months (mean 76.7 ± 53.5). The results of study showed that 70 patients (24.5%) to be noncompliant (7.7% noncompliant minor and 16.8% noncompliant major). The time since the date of transplanation was a significant risk factor in both noncompliant minor and major groups (P < 0.001 and P < 0.001). The other risk factors associated with major noncompliance was young age (P < 0.001), lower level of education (P < 0.01), lower socioeconomic class (P < 0.05), addiction and psychiatric disorders (P < 0.05). Transplant recipients with major noncompliance also had more acute rejection episodes (P < 0.001) and allograft dysfunction (P < 0.01). We conclude that noncompliance with immunosuppressive medications is very common in renal transplant recipients and it results to significant acute rejection episodes and allograft failure.
Transplant Tourism and the Iranian Model of Renal Transplantation Program: Ethical Considerations
(Başkent Üniversitesi, 2005-12) Ghods, Ahad J.; Nasrollahzadeh, Dariush
Currently, the buying and selling of kidneys through “transplant tourism” is occurring at an increasing rate, both in developed and developing countries. Since 1988, Iran has adopted a compensated and regulated living-unrelated donor renal transplant program, and by providing financial incentives to volunteer living donors, has eliminated the renal transplant waiting list. In the Iranian model of renal transplantation program, regulations have been put in place to prevent transplant tourism. Foreigners are not allowed to undergo renal transplantation from Iranian living-unrelated donors. They also are not permitted to volunteer as kidney donors for Iranian patients. A study at the transplant unit of Hashemi Nejad Kidney Hospital in Tehran, Iran, showed that of 1881 renal transplant recipients, 19 (1%) were Afghani or Iraqi refugees, 11 (0.6%) were other foreign nationals, and 18 (0.9%) were Iranian immigrants. Renal transplantations seemed ethically acceptable to all refugees and foreign nationals. However, transplantation of Iranian immigrants who had been residing abroad for years constituted true transplant tourism.