Transplantation is the best treatment of end-stage renal disease (ESRD. Life expectancy, the quality of life and reduced medical expenses are greater with kidney transplantation than with maintenance dialysis. However, organ shortage remains the central problem in kidney transplantation. To tackle this problem, we, in Iran, have initiated a living unrelated donor (LURD) program using emotionally related persons, friends and well-motivated volunteers as organ donors, which resulted in eliminating the waiting list. The Iranian transplant program is the most active in the Middle East region in providing equitable, quick, and intermediary-free access to affordable kidney transplantation for everyone regardless of gender and economic circumstances. The results of transplants from living unrelated donors have been very encouraging. This article deals with the kidney transplantation practice in Iran and other Middle Eastern countries, and describes Iran’s kidney transplantation experience with cadaveric, living related and living unrelated donors. In conclusion, kidney transplantation experience in the Middle East region is an active practice. Most countries have uplifting trends and effectve programs are establishing inside countries. However, the practice should be further promoted and organized towards allograft procurement from deceased donors and in this way passing and enacting proper legislations must be more seriously taken into consideration.

Keywords: renal transplantation, Kidney, Iran model, Middle East, ESRD