The MESOT region Population = 600 m GNI: $2,387 - $79,426 GDP: $ 32 - 991 Billion Turkey 74 m Syria 23m Tunisia 10.6 m Iraq 32m Iran 75 m Morocco 33m Lebanon 4.5m Jordan 6.5m Kuwait 2.8m Pakistan 177m Algeria 37m Libya 6.4 m Egypt 82 m UAE 1.9 m Saudi Arabia 28 m Oman 2.8 m Iran and Turkey Saudi Arabia & Gulf States Region North African Region Eastern Mediterranean region Mid Asian Region Human Development Report 2011 Yemen 25 m

Transplantation in MESOT Transplantation in the MESOT countries started sporadically with renal transplants as early as 1967 by Dr. Sanadizadeh city of Shiraz the Islamic Republic of Iran (Iran). Lebanon ( with Dr A Daouk), in 1972 Sudan 1972 Jordan in 1972( HE Dr. Daoud Hanania and Dr. Said Karmi) Iraq in 1973 ( with Dr Walid Al Khayal Turkey in 1975 ( with Dr. Mehmet Haberal) The other countries followed quickly Palestine being the last country to start in 2011

The first organ transplantation in each country Renal Liver Cardiac Pancreas Lung Algeria 1986 Bahrain 1995 Egypt 1976 Jordan 1972 2004 1985 Iran 1968 1993 2006 2000 KSA 1979 1990 Kuwait Lebanon 1997 2008 Libya 1992 2005 Morocco Oman 1988 Pakistan 2003 Palestine 2011 Qatar 1989 Syria Turkey 1975 1998 Tunisia UAE Yemen Iraq 1973

Transplant activity in MESOT 2010-2015

Number of transplant per country (2010-2015)   inside country outside Total Country Population Deceased live Forgeiner forgeiner Forgiener forgiener related Non paired non Related Algeria 39,980,000 116 22 138 2 133 24 159 122 23 145 126 30 156 166 19 204 235 Azerbgian 9,826,397 1 225 226 13 243 256 45 294 339 65 315 380 76 389 854 92 518 610 Bahrain 1,248,348 5 10 8 18 Egypt* 93,383,574 1200 1417 147 985 Jordan 6,508,887 4 252 39 295 7 218 33 258 206 41 296 11 192 28 231 Iran 80,043,146 590 112 1624 77 2403 763 98 1431 56 2348 911 99 1448 62 2520 1171 100 1451 95 2817 1122 1126 60 2445 1433 70 1024 14 2541 Iraq 33,330,000 185 32 217 180 210 224 25 249 230 36 266 237 37 274 240 40 280 KSA 26,534,504 313 106 611 177 682 118 432 74 830 96 406 211 769 131 466 48 171 987 144 580 55 779 Kuwait 2,646,314 12 3 16 81 26 54 124 31 107 44 168 63 123 Lebanon 4,140,289 34 42 80 15 111 109 66 91 6 Libya 6,733,620 64 17 Morocco 32,309,239 43 46 20 35 Oman 3,090,150 57 49 Pakistan** 190,291,129 602 933 1537 581 814 1395 471 780 1251 392 1081 1473 327 588 915 361 976 1337 Palastine 2,510,000 38 Syria 22,530,746 141 222 363 82 175 257 72 154 104 86 209 Turkey 79 409 926 398 520 2231 71 2952 524 2092 121 2905 585 2031 73 130 2942 626 1974 78 120 2799 670 2116 125 3201 Tunisia 10,732,900 102 132 110 134 88 83 87 UAE 5,314,317 21 50 Yemen 24,771,809 Qatar 1,951,591 29

Kidney transplantation (living /deceased)

Renal Transplants total vs outside the country 2010-2015

Over all Liver transplantation 2010-2015

Heart transplant 2010-2015

Pancreas transplant 2010-2015

Laws and legislations Brain Death Transplant law Government Support   Brain Death Transplant law Government Support National Ethic Committee PMT training Transplant Coordinator Support for therapy Algeria yes Bahrain Egypt NA Partial Jordan No Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan No (10 yes (2) Palestine Qatar Syria Turkey Tunisia UAE Yemen

The Kuwait document The Kuwait Statement on Cell Tissue and Organ Transplantation 27 November 2006 Participants[*] in the WHO Informal Regional Consultation on Developing Organ Donation form Deceased Donors, held in Kuwait City, Kuwait, on 26–27 November 2006: 1. Support the development and expansion of organ and tissue donation from deceased donors in all countries of the Eastern Mediterranean Region; 2. Oppose commercialism and transplant tourism, including brokerage and medical professionals seeking monetary profit as a result of the vendor sale or coerced donation of an organ or tissue; the placing of an arbitrary monetary value on an organ or tissue; the sole motivation by a vendor to undergo organ or tissue retrieval for monetary gain. 3. Support the identification of the procedural steps to develop organ and tissue donation from deceased donors, which should include: Development of a national legal framework that enables organ and tissue donation from deceased donors with death determined by internationally accepted neurological or cardio-respiratory criteria; Establishment of a national organization responsible for: organ and tissue donation from deceased donors and allocation; engaging the public sector in educating society in support of organ and tissue donation from deceased donors; engaging professionals and ensuring the knowledge and skill to determine death by criteria that enable organ and tissue donation from deceased donors; oversight of the proper care and follow-up of live donors and transplant recipients; maintaining a registry of (living and deceased) donor and recipient data to ensure transparency and accountability for human material, transplantation practice and outcome. 4. Urge all governments to appropriate the necessary legal, administrative, and financial resources to implement these recommendations through a national transplant authority. Call upon the International Society for Nephrology, the Transplantation Society and the Global Alliance for Transplantation to take note of and communicate to partners the principles contained in the Kuwait Statement on Cell Tissue and Organ Donation. Participants will communicate the Kuwait Statement to their respective ministries of health and bring it to the attention of the next session of the WHO Regional Committee for t he Eastern Mediterranean. In the Eastern Mediterranean Region, the Middle East Society for Transplantation (MESOT), in partnership with WHO and using the WHO guiding principles on transplantation, will support countries in the implementation of the Kuwait Statement on Cell Tissue and Organ Transplantation.

Acknowledgment MESOT (Society, council and all its Members) WHO IMF FAO MTN DICG