Solid-Organ Transplant Activity in MESOT Countries

RegistRy RepoRt Corrected and Republished

Solid-Organ Transplant Activity in MESOT Countries Marwan Masri,1 Mehmet Haberal2

Key words: Bone marrow mononuclear cells, Transplant, Autologous, Leg, Ischemia, Stem cell Introduction MESOT members are a dynamic force in drafting, finalizing, propagating, gain, and enforcing the ethical charter in Transplantation (the Istanbul Declaration). In accordance with the Declaration’s guiding principles: “Oversight requires a national or regional registry to record deceased and living donor transplants”; the MESOT is set to establish a regional transplant registry whose purpose is (1) to identify the strengths and weaknesses of each center. “Countries with well-established deceased-donor 1Immediate Past President, Middle East Society for Organ Transplantation; Member, Istanbul Declaration Custodian Group; Associate Editor, Experimental and Clinical Transplantation; CEO, Transmedical For Life, Beirut, Lebanon 2Founder and President-Elect, Middle East Society for Organ Transplantation; Member, Istanbul Declaration Custodian Group (DICG); Editor-in-Chief, Experimental and Clinical Transplantation; Founder and Founder President, Baskent University, Ankara, Turkey On behalf of Antoine Stephan, Gaby Kamel, and Antoine Barbari from Lebanon; Bassam Saeed, Lina Assad, and Rania Derani from Syria; Abdel Hadi Breizat, Tareq Suheimat, and Riyad El Said from Jordan; Adel Baker and Rashad Barsoum; Refaat Kamel and Tarek El Baz from Egypt; Faissal Shaheen and Besher Attar from Saudi Arabia; Gokhan Moray and Gulnaz Arslan from Turkey; Mustafa Al Mousawi from Kuwait; Malek Hosseini, Hassan Argani, Ahad Ghods, Nasser Simforoosh, Fatemeh Ghaemi, Behrooz Broumand, F. Zahedi, B. Larijani, and Iraj Fazel from Iran; Nabil Mohsin from Oman; Ibrahim Elnono from Yemen; Munir Abudher from Libya; Lydia Benhocine, Farid Haddoum, and Rabia Bayahia from Algeria and Morocco; Taieb Ben Abdallah and Aziz El Matri from Tunisia; Ali Abdul Kareem Alobaidli and Mona Al Rokhaimi from The UAE; Anwar Naqvi and Adibul Rizvi from Pakistan; Sadiq Abdulla and Ahmed Al Arrayed from Bahrain; Yousef Al Maslamani and Hassan Ali Mohd. Hasan Al-Malki from Qatar; Mohammed Ayyoub from Palestine; Walid Al-Khayal from Iraq Corresponding author: Mehmet Haberal, MD, Baskent University, Taskent Cad. No: 77, Bahcelievler, 06490 Ankara, Turkey Phone: +90 312 212 7393 Fax: +90 312 215 08 35 E-mail: [email protected]

Experimental and Clinical Transplantation (2013) Suppl 1: 1-8

Copyright © Başkent University 2013 Printed in Turkey. All Rights Reserved.

transplant programs are encouraged to share information, expertise, and technology with countries seeking to improve their organ donation efforts; (2) to address these needs; and (3) to establish programs that empower the transplant programs in all regional countries by joining a comprehensive and accepted data registry system. This system is necessary for the MESOT country, and is not inconsistent with national self-sufficiency so long as the collaboration (i) protects the vulnerable population, (ii) promotes equality between donor and recipient populations, and (iii) does not violate the principles set forth by the Istanbul Declaration. Finally, it should (4) establish a unified criterion for organ donation and organ sharing. Establishing the registry requires that each country should have its own National Registry and voluntarily contributes to the regional registry, the MESOT. The reporting may be performed directly by the center or via the National Registry. To do this, a unified reporting system is needed for both the donor and the recipient. The reporting system should be based on a computer system that acts as a virtual office. The MESOT has established a committee to start such a Registry. The duties of the committee are based on a design to collect the data, to oversee of data implementation and collection, and finally, to analyze and report data (preferably at each MESOT Congress) in a regular manner. This paper describes the current and historical solid-organ transplant programs in each of the MESOT countries. The data were collected voluntarily and verified by the countries. Materials and Methods Each country was asked to fill in data for each organ about (1) the date that the program began; (2) the number of transplants during 2012 in the country

Doi: 10.6002/ect.2013.ecte3b

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Marwan Masri, Mehmet Haberal /Experimental and Clinical Transplantation (2013) Suppl 1: 1-8

(either deceased or living); (3) the number of transplants performed outside the country (either deceased or living); (4) the total number of transplants from the program’s beginning until the end of 2012; and (5) the laws regarding transplants and the national support for the program. Data for the outcomes for live- related and transplants that were not related were not requested. Data were tabulated using Microsoft Excel (Version 7), and analyzed for total number of transplants, the number of transplants per million of the population, and the minimal and maximal numbers. Results Transplanting in the MESOT countries began with renal transplants being performed as early as 1968, by Dr. Sanadizadeh in Shiraz, the Islamic Republic of Iran; and then in Lebanon (with Dr A. Daouq); then Jordan in 1972 (with HE Dr. Daoud Hanania and Dr. Said Karmi in Iraq in 1973 (with Dr. Walid Al Khayal); and then ultimately in Turkey in 1975 (with Dr. Mehmet Haberal). The other countries followed, with Palestine being the last country to start in 2010 (Table 1). The first cardiac transplant was performed in 1985, in Jordan, by HE Dr. Daoud Hanania, and he continued from January 1, 2012, until December 15, 2012. There were 7990 renal, 1682 liver, 303 pancreatic, 163 hearts, and 59 lung transplants performed in the MESOT countries (Figure 1). The cumulative number of transplants from the beginning of the program until the end of 2012 was 84 943 renal transplants (of which 10 728 were

recovered from deceased donors), 10 285 liver transplants (of which 3956 were recovered from deceased donors), 1307 hearts, 303 pancreatic (of which 302 were recovered from deceased donors), and 212 lungs (of which 211 were recovered from deceased donors) (Figure 2). Historical Notes 1. Turkey1-4: a. The first cardiac transplant was performed by Dr. Kemal Beyazit on November 22, 1968. b. The first living renal transplant was performed by Dr. Mehmet Haberal on November 3, 1975. c. The first deceased-donor renal transplant was from Eurotransplant, and was performed by Dr. Haberal on October 10, 1978. d. The first local deceased-donor kidney transplant was performed by Dr. Haberal on July 27, 1979. e. The first deceased-donor liver transplant in Turkey and the region was performed by Dr. Haberal, on December 8, 1988. f. The first pancreatic transplant in Turkey was performed by Dr. Fahrettin Alparslan on November 1989. g. The first pediatric segmental living-related liver transplant in Turkey, the region, and Europe was performed by Dr. Haberal on March 15, 1990. Figure 1. The Total Number Of Transplants Performed in the MESOT Per Organ From January 1, 2012 Until December 15, 2012

table 1. The First Organ Transplant by Country Country Algeria Bahrain Egypt Jordan Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey Tunisia UAE Yemen Iraq

Renal 1986 1995 1976 1972 1968 1979 1979 1972 1992 1986 1988 1979 2011 1979 1975 1986 1985 1998 1973

Liver

2004 1993 1990 1990 1997 2005

Organ Cardiac

1985 1993 1986 1997

Pancreas

Lung

2006 1986 1985 2008

2000 1986

1998

2004

2000

1993 2003

1988 1998

1968

Figure 2. Cumulative Data for the Number of Transplants From the Start of the Program Until the End in 2012


h. The first adult segmental living-related liver transplant in the world was performed by Dr. Haberal on April 24, 1990. i. The first combined living-related liver-kidney transplant in the world was performed by Dr. Haberal on May 16, 1992. 2. Jordan5-7: a. The first cardiac transplant in the MESOT was performed by HE Dr. Daoud Hanania in 1985. b. The first kidney transplant in Jordan was performed by HE Dr. Daoud Hanania. 3. Iran8-18: a. The end of year for Iran is March 21, 2013, and not December 31 (data are only until December). b. First live-donor kidney transplant was performed by Dr. Sanadizadeh in Namazi Hospital Shiraz in 1968. c. First deceased-donor kidney transplant was performed in Shiraz 2003. d. First live-donor liver transplant was performed by Dr. Malekhosseini, at Namazi Hospital in Shiraz, Iran, 1993. e. First deceased-donor liver transplant was performed by Dr. Malekhosseini at Namazi Hospital in Shiraz, Iran. f. First cardiac transplant was performed in Tehran, in 1993. g. First lung transplant was performed at the Imam Khomeini Hospital, Tehran, Iran 2000. h. First pancreatic transplant was performed by Dr. Ali Malek Huseini at the Namazi Hospital in Shiraz, Iran, in 2006. i. The first heart transplant was performed at Shariati Hospital in Tehran, Iran, 1993. j. Fourteen deceased-donor kidneys were imported by the Eurotransplant Network and were transplanted from 1968 to 1980. k. The first bone marrow transplant was performed at Shariati Hospital in Tehran, Iran, 1991. l. The first corneal transplant was performed in 1935 in Tehran, Iran. 4. Pakistan19-23: a. Data for 2011 and 2012 are not yet available. b. The first live-donor kidney transplant was performed by Dr. Mkhtar Hamid Shah at an

c.

d.

f.

g.

h.

3

army hospital in 1979. The first deceased-donor kidney transplant was performed in SIUT by Dr. Adib Rizvi and Dr. Anwar Naqvi in 1995. First locally recovered deceased-donor kidney transplant was performed at SIUT by Dr. Adib Rizvi and Dr. Anwar Naqvi in 1998.e. The first liver transplant was performed at SIUT by Dr. Adib Rizvi and Dr. Anwar Naqvi in 2003. SIUT: of all the kidney transplants there were performed in 1985 to 2011, 3449 these were performed by Dr. Adib Rizvi and Dr. Anwar Naqvi. Data from HOTA registry excluding SIUT (September 5, 2007, to December 31, 2011): 1366. Deceased-donor kidneys: 8 were from local deceased-donors, and 23 were courtesy of Eurotransplant (SIUT, Dr. Adib Rizvi and Dr. Anwar Naqvi).

5. The UAE24-26: a. The 2 deceased-donor kidney transplants were donated courtesy of Eurotransplant. b. The first living-donor transplant was performed by Dr. Abdalah Daar. c. The first deceased-donor kidney transplant was performed by Dr. IK Dahwan22. 6. Kuwait27-30: a. One hundred deceased-donor kidneys were from outside Kuwait. b. The first live-related renal transplant was performed by Dr. George Abouna. c. The first deceased-donor renal transplant was performed by Dr. George Abouna. 7. Egypt31-38: a. Mansoura Center performed 2380 livingdonor renal transplants. b. (The first was performed by Dr. Mohammad Ghoneim in 1976). c. The Cairo Kidney Center performed 659 living-donor renal transplants. 8. Iraq39-41: a. Personal contact (data were not provided by the country and were not included in the analyses).

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b. The first live-donor kidney transplant was performed by Dr. Walid Al Khayal in 1973. c. The first life-donor liver transplant was performed by Dr. Assad Hassoum. 9.

Lebanon42-46: a. The first renal transplant was performed by Dr. A. Itani at Barbir hospital. b. The first deceased-donor renal transplant was performed by Dr. Gaby Kamel. c. The first liver transplant performed by HE Dr. Mohammad Khalifa. d. The first cardiac transplant was performed by Dr. Mohammad Saab and Dr. Fayez Abou Jaoude. e. The first lung was performed by Dr. Maroun Abou Jaoude.

10. Kingdom of Saudi Arabia47-52: a. The first kidney transplant was performed by Dr. J. Thompson and Dr. Anthony Wing. a. The first deceased-donor kidney transplant was performed by Ketab Al Otaibi and Rene Chan. 11. Syria53-55: a. The first kidney transplant was performed by HE Dr. Maher Housami.

15.Tunisia63-65: a. The first live transplant was performed by Dr. Saadeddine Zemrli. 16.Libya66-67: a. The first live kidney transplant was performed by a visiting Polish team at the Al Zahra Hospital. 17.Yemen68-70: a. The first kidney transplant was performed by a visiting team from Mansoura University in Sana. b. The first kidney transplant in Aden was by Dr. Nadey Hakim. Laws Nearly all MESOT countries, with the exception of Jordan, Syria, and the UAE have laws regarding brain death. Transplants are supported by the government, and most of them have training programs for their transplant coordinators. A national ethics committee is available in all of these countries (Table 2).

13.Oman56-60: a. The first live-donor kidney transplant was performed by Dr. Abdallah Daar. b. The first deceased-donor was performed by Dr. Abdalah Daar. c. Professors A.S. Daar and N. Mohsin are the holders of the World Record for the Youngest Donor in Renal Transplantation (Transplant Worldwide Records. Terasaki PI, Cecka JM, Los Angeles, UCLA; 1996:513). d. Two and 1 kidneys from deceased-donors were from Eurotransplant in Saudi Arabia 1995 and 1996.

Renal transplantation Of the 7990 renal transplants, 1379 transplants (17.3%) were from deceased donors, and 6611 were from living donors. In 2012 there were 8 countries (Bahrain, Jordan, Egypt, Libya, Oman, Qatar, the United Arab Emirates [UAE], and Yemen) that had no deceased donations (Table 3). The number of transplants per country is listed in Table 3. The number of transplants per million people in the population varied from as low as 1 in Yemen, to as many as 32 in Turkey (Table 3). The total number of renal transplants from the beginning of the program until the end (which is December 15, 2012) that were performed in the MESOT countries is 88 937 transplants, of which 10 727 were from deceased donors and 74 210 were from living donors (Table 3). The start of the deceased-donor program in Pakistan, Kuwait, Turkey, and the UAE was made possible by a generous donation from Eurotransplant. The first locally recovered deceased renal transplant was performed in Ankara, Turkey, by Dr. Mehmet Haberal in 1979.

14.Qatar61-62: a. The first kidney transplant was performed by Dr. Ali Hijazi.

Liver transplantation The first deceased-donor liver transplant was performed in 1988 in Turkey, by Dr. Mehmet Haberal.

12. Bahrain6: a. The first live-donor kidney transplant was performed by Dr. George Abouna.

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table 2. Governmental Support and Ethical Laws in Each Country Country

Brain Death

Transplant Law

Law Date

Government Support

National Ethics Committee

PMT Training

Transplant Coordinator

Algeria

Yes

Yes

December16,1985 (LawNo.85-05)

Yes

Yes

Yes

Yes

Bahrain Egypt Jordan

Yes NA No

Yes Yes Yes

Yes Partial Yes

Yes NA Yes

Yes NA No

Yes NA No

Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey3,4

Yes Yes Yes Yes Yes Yes Yes Yes NA Yes No Yes

Yes Yes Yes Yes Yes Yes Yes Yes NA Yes Yes Yes

Yes Yes Yes Yes Yes Yes Yes No(10) NA Yes Yes Yes

Yes Yes Yes Yes Yes No Yes Yes NA Yes Yes Yes

Yes Yes Yes Yes Yes No Yes Yes(2) NA Yes Yes Yes

Yes Yes Yes Yes Yes No Yes Yes NA Yes Yes Yes

Tunisia TheUAE Yemen Iraq

Yes No No Yes

Yes Yes Yes Yes

Yes Yes Yes Yes

Yes Yes No NA

Yes Yes

Yes Yes No NA

2010 1.CornealDonation December16,1956 2.HumanOrgansUtilization June1,1977 2000 1986 December20,1987 8/199(No.1/509) August27,1999(LawNo.16-98) 1993 March2010 NA NA June3,1979 (Law2238-withconsent) December21,1982 (Law2594-w/outconsent) March25,1991(LawNo.91-22) 1993 Law26,2002 1985

NA

Abbreviations: NA, not available; Partially, depends on situation

table 3. Number of Renal Transplants Performed in the Various MESOT Countries Including Transplants/Million Population for Live Donation, Deceased Donation, and the Cumulative Number From the Start of the Program Until the End of 2012 Country

Deceased Algeria Bahrain Egypt Jordan Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey Tunisia TheUAE Yemen Iraq* Total

2012

Number

2 0 0 0 771 118 30 12 0 4 0 0 0 3 0 437 2 0 0 1379

Live 95 10 985 138 1508 513 40 80 17 32 14 631 32 5 363 1979 124 17 26 212 6611

Deceased 0.054 0.000 0.000 0.000 9.776 4.447 11.337 2.898 0.000 0.124 0.000 0.000 0.000 1.537 0.000 5.829 0.186 0.000 0.000

Many other firsts also were performed by Dr. Mehmet Haberal during this period: On March 15, 1990, he performed the first pediatric segmental living-related liver transplant in Turkey, the region and Europe, followed just 1 month later on April 24, 1990, with the first adult segmental living-related liver transplant in

Per Million Live

Total

2.561 8.011 11.770 21.202 19.120 19.333 15.115 19.322 2.525 0.990 4.207 3.316 13.546 2.562 16.111 26.396 11.553 3.199 1.050

2.615 8.011 11.770 21.202 28.896 23.780 26.452 22.221 2.525 1.114 4.207 3.316 13.546 4.099 16.111 32.225 11.740 3.199 1.050

Cumulative Data Start of the Program Until the End of 2012 Deceased Live 10 20 0 56 3483 2467 448 167 0 12 11 31 0 6 0 3721 293 2 0

945 100 8590 2917 28373 5365 1291 1274 347 274 223 4815 60 128 4000 13240 1075 105 1079

10728

74215

Total 955 120 8590 2973 31856 7832 1739 1441 347 286 234 4846 60 134 4000 16961 1368 107 1079 5676 84943

the world. In May 1992, he performed the first combined liver-kidney transplant from a living-related donor, which again was the first operation of its kind. Today, more than 1800 liver transplants are being performed annually because Turkey, Iran, and the Kingdom of Saudi Arabia (KSA) have active programs

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table 4. Distribution of Liver Transplants in the MESOT Countries Country

2012

Number Deceased Live

Algeria Bahrain Egypt Jordan Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey Tunisia UAE Yemen Iraq Total

0 0 0 2 338 50 0 1 0 0 0 0 0 2 0 227 1 0 0 621

1 0 288 14 57 86 0 0 0 0 0 0 0 0 0 615 1 0 0 1 1062

Deceased 0.000 0.000 0.000 0.307 4.286 1.884 0.000 0.242 0.000 0.000 0.000 0.000 0.000 1.025 0.000 3.028 0.093 0.000 0.000

Live

Total

Cumulative Data Start of the Program Total Until the End of 2012 Deceased Live

0.027 0.000 3.441 2.151 0.723 3.241 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 8.203 0.093 0.000 0.000

0.027 0.000 3.441 2.458 5.008 5.125 0.000 0.242 0.000 0.000 0.000 0.000 0.000 1.025 0.000 11.231 0.186 0.000 0.000

0 0 0 3 1347 671 2 19 0 0 0 1 0 3 0 1881 27 2 0

34 0 1900 160 210 559 0 0 21 0 0 3 0 0 0 3436 6 0 0

34 0 1900 163 1557 1230 2 19 21 0 0 4 0 3 0 5317 33 2 0

3956

6329

10285

Per Million

for both deceased-donor and live-donors, and Egypt with a live-donor program only. Jordan has also started a liver program which is promising as shown in Table 4. Cardiac transplantation Cardiac transplant began in Jordan at the King Hussein Medical city in 1986, and then was followed quickly by the KSA and Turkey. In 2012, cardiac transplants were performed only in Iran, the KSA, Turkey, and Lebanon, with Iran leading the way with 86 transplants until December 2012. The cumulative data indicate that only 9 counties performed cardiac transplants (Table 5).

table 5. Distribution of Cardiac Transplants Among Various MESOT CountriesMESOT Countries 2012

Per Million Population 2012

Cumulative (Start of the Program Until the End of 2012)

0 0 0 0 86 22 0 3 0 0 0 0 0 0 0 52 0 0 0

0.000 0.000 0.000 0.000 1.090 0.829 0.000 0.725 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.694 0.000 0.000 0.000

0 0 0 11 448 228 0 36 0 1 0 0 0 8 2 558 17 0 0

Country Algeria Bahrain Egypt Jordan Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey Tunisia UAE Yemen Iraq Total

163

1307

pancreatic transplantation Pancreatic transplants began in Kuwait in 1985, and it is currently (33 in 2012) being performed in Iran, Turkey, and Kuwait. Historically, there were 19 transplants in the KSA and 1 in Lebanon and Qatar (Table 6). Lung transplantation Only 3 countries—Iran, the KSA, and Turkey—are performing lung transplants in the MESOT. There were 33 lung transplants in 2012, all of which were from deceased donors. Two other countries, Lebanon and Jordan, each had 1 transplant (Table 7).

table 6. Distribution of Cardiac Transplants Among Various MESOT Countries 2012 Country

Algeria Bahrain Egypt Jordan Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey Tunisia TheUAE Yemen Total

Number Deceased 0.000 0.000 0.000 0.000 24 0 3 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 6 0.000 0 0.000 33

Live 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0

Per Million Deceased 0.000 0.000 0.000 0.000 0.304 0.000 1.134 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.080 0.000 0.000 0.000

Live 00 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000

Total 0.000 0.000 0.000 0.000 0.304 0.000 1.134 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.080 0.000 0.000 0.000

Cumulative Data From the Start Until the End of 2012) Deceased Live 0 0 0 0 0 0 0 0 110 0 19 0 7 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 164 0 0 0 0 0 0 0 302 1

Total

0 0 0 0 110 19 8 1 0 0 0 0 0 1 0 164 0 0 0 303


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table 7. Distribution of Lung Transplants Among the Various MESOT Countries 2012 Country

Algeria Bahrain Egypt Jordan Iran KSA Kuwait Lebanon Libya Morocco Oman Pakistan Palestine Qatar Syria Turkey Tunisia TheUAE Yemen Total

Number Deceased 0 0 0 0 24 14 0 0 0 0 0 0 0 0 0 21 0 0 0 59

Live 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Per Million Deceased 0.0000 0.0000 0.0000 0.0000 0.3043 0.5276 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.2801 0.0000 0.0000 0.0000

Conclusions 1. All countries are working to achieve self sufficiency at least for renal transplants. 2. Religious obstacles is a misconception as the most religious adherent countries (eg, the KSA, Kuwait, Iran, and Turkey) have the highest deceased donations. 3. Social barriers may be an obstacle that could be elevated by education. 4. Government support has helped many countries. 5. We need a data registry system as a dynamic process. It should be filled voluntarily by each country, each year, with more valuable remarks (such as the recipient survival, complications in each organ, graft survival, and organ transplant barriers in each of the countries). References 1. Haberal M, Bereket G, Karakayali H, Arslan G, Moray G, Bilgin N. Pediatric renal transplantation in Turkey: a review of 56 cases from a single center. Pediatr Transplant. 2000;4(4):293-299. 2. Karakayali H, Haberal M. The history and activities of transplantation in Turkey. Transplant Proc. 2005;37(7):2905-2908. 3. Haberal M, Moray G, Karakayali H, Bilgin N. Transplantation legislation and practice in Turkey: A brief history. Transplant Proc. 1998;30(7):3644-3646. 4. Haberal M. Historical evolution of kidney and liver transplantation in Turkey. Transplant Proc. 1995;27(5):2771-2774. 5. Al Sayyari AA. The history of renal transplantation in the Arab world: a view from SaudiArabia. Am J Kidney Dis. 2008;51(6):10331046. 6. Hazza I, Al-Mardini R, Salaita G. Pediatric renal transplantation: Jordan's experience. Saudi J Kidney Dis Transpl. 2013;24(1):157161.

Live 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000

Total 0.0000 0.0000 0.0000 0.0000 0.3043 0.5276 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.2801 0.0000 0.0000 0.0000

Cumulative Data From the Start Until the End of 2012) Deceased Live 0.000 0.0000 0.000 0.0000 0.000 0.0000 1 0.000 110 0.000 61 0.000 0.000 0.0000 0.000 0.0000 0.000 0.0000 0.000 0.0000 0.000 0.0000 0.000 0.0000 0.000 0.0000 0.000 0.0000 0.000 0.0000 39 0.000 0.000 0.000 0.000 0.000 0.000 0.0000 211 1

Total

0 0 0 1 110 61 0 1 0 0 0 0 0 0 0 0.0000 0.0000 0.0000 0 303

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Correction and Republication: solid-organ transplant Activity in Mesot Countries

During the publication process, a number of errors occurred in the article by Marwan Masri, Mehmet Haberal (Exp Clin Transplant 2013;11(2):93-98). During the publication process all of the Tables and Figures were omitted from the article. The corrected version of the article has had all Tables and Figures included.

The corrected version has been republished in Exp Clin Transplant 2013;11(suppl 1):1-8. It is available online at http://www.ectrx.org/forms/ectrxcontent show.php?doi_id=10.6002/ect.2013.ect3b. Please do not cite the old version. We apologize to the authors and our readers for this error.