LAUSR

As mentioned in the “Trends in organ donation and transplantation over the past eighteen years in Iran.”1 “Between 2500 and 4000 brain deaths occur annually in Iran. In 2019, Iran reached a high of 14.3 donors per million population (PMP); despite this, 7−10patients on thewaiting list die every day” . . . . “. . .Even though Iran has the most successful rate of organ donation and transplantation in this region, the rate of PMP in Iran is lower than that of other countries such as Spain (49 PMP), the United States (36.38 PMP), and Croatia (34.63 PMP)”.1 Theorgandonation and transplantation system in Iranhas been successful as compared to other countries in the MESOT region and Asia in terms of the number of donations. However, the number of donors permillion population (PMP) is lower than in other countries like Spain, France, and the United States. According to ministry of health,2 approximately 2500–4000 brain deaths occur annually in Iran, and the country had a donor rate of 14.3 PMP in2019. The number of patients in needof a transplanted organ in the country ismore than18000people.Organdonation index (number of donors per year per million people) or PMP = 14.3, Acceptable rate is: 25. To improve the organ donation and transplantation system in Iran, we need to increase the donor pool. We also mention in our paper, Iran has an Opt-in consent legislation system.1 The final decision for organ donation is given by families. However, almost 40% of brain death cases are lost due to families’ refusal of organ donation. This shows one of the weak points of the system and needs improvement. The consent rate and donor management in cases of brain death are still unacceptable, with the overall family consent rate in the country being 60.63%, indicating room for progress.3 Coordinators need the training to increase their efficiency in terms of family approach.4 Moreover, the national deceased donation rate is still below the proposed acceptable target of 25 PMP and well below those of countries leading in organ donation. Organ donation is unevenly distributed in Iran, ranging from 0 to 42 donations PMPs in different provinces, highlighting the need for improvement in organ donation rates across the country (Table 1). Therefore, considering the high potential of transplant centers, transplant surgeons, and the number of brain deaths in Iran, we expect a higher deceased donation rate in our country. To address this issue, the Organ Procurement Units (OPU) and Recognition Centers (RCs) have been established to cover all areas of Iran. In addition, the transplant centers have been strategically distributed based on the transplant poles to ensure that all patients