Transplantation in Turkey

BASKENT UNIVERSITY

Mehmet HABERAL, MD, FACS, FICS (Hon) Professor, Surgery Chairman, Department of General Surgery, Transplantation and Burn Institutes, Faculty of Medicine, Founder and President, Baskent University

Transplantation Activities in Turkey

1. Transplantation 2. Legislation and Organ Donation 3. Facilities, Societies, and Scientific Activities 2 TRANSPLANTATION IN TURKEY Transplantation

Transplantation

3 TRANSPLANTATION IN TURKEY Transplantation

Ankara University School of Medicine, 1967

I would like to give you some brief historical Following my graduation from the Ankara data about my background so that you may University School of Medicine in Ankara, in better understand the development of 1967, transplantation in Turkey. TRANSPLANTATION IN TURKEY Transplantation

Residency at Hacettepe University Medical School, Department of General Surgery, 1967

I joined the Department of General Surgery at Hacettepe University Medical School, in July 1967, as resident. TRANSPLANTATION IN TURKEY Transplantation

Dr. Christiaan Barnard, World’s First Heart Transplantation, 1967

During my residency, I was very interested The late 60s were a very important time in in a variety of experimental studies, medicine. On December 3, 1967, especially those being done in dogs. Dr. Christiaan Barnard had just performed the world's first heart transplantation in Cape Town, South Africa. TRANSPLANTATION IN TURKEY Transplantation

Ankara İstanbul

Following this, in 1969, 2 heart transplantation trials were performed in Turkey-one in Ankara and one in Istanbul. Unfortunately, both were unsuccessful. TRANSPLANTATION IN TURKEY Transplantation

Experimental Animal Studies, Hacettepe University, 1970s

In 1970, a transplantation research program We began by performing experimental liver was established at Hacettepe University in transplantations in pigs using porta-right the Department of General Surgery, and I arterial bypass, but this method proved was one of the members of the surgical unsuccessful. We stopped our studies using team. At that time, I was in my third year of pig models, and I decided to continue the residency. program using dogs this time. This method, without bypass, proved successful. TRANSPLANTATION IN TURKEY Transplantation

Assistant Professorship at Hacettepe University Medical School, 1971

Upon completion of my residency in 1971, I was appointed Assistant Professor in the Department of General Surgery at Hacettepe University Medical School. TRANSPLANTATION IN TURKEY Transplantation

Fellowship at Shriners Burns Institute & John Sealy Hospital, Texas 1973

In addition to the transplantation models I After several months of eager anticipation, was working on, I also was greatly I was accepted as a fellow at the Shriners interested in burn care. I therefore decided Burns Institute and at John Sealy Hospital in to apply to several universities in the United Galveston, Texas. And so, in February States with the hopes of going there and 1973, I went to the United States, where I learning more about these 2 exciting and studied with Drs. Duane Larson and Mario growing fields. TRANSPLANTATION IN TURKEY Transplantation

Dubokowsky and learned a great deal about clinical burn care and rehabilitation, and experimental studies. TRANSPLANTATION IN TURKEY Transplantation

Application Letter to Dr. Thomas Starzl, University of Colorado, Denver, 1973

And yet, I wanted to learn more about transplantation. Therefore, after this fellowship, I sent letters to many transplantation centers in the United States, one of which was to Dr. Thomas Starzl at the University of Colorado, School of Medicine, in Denver. 12 TRANSPLANTATION IN TURKEY Transplantation

Dr. Thomas Starzl, First Physician in the World to Perform Clinical Liver Transplantation, 1963

As you most likely know, Dr. Starzl was the first physician in the world to perform a clinical liver transplantation in 1963, and successfully in 1967. TRANSPLANTATION IN TURKEY Transplantation

Acceptance of my fellowship by my own means, University of Colorado, Denver, 1973

Dr. Starzl accepted my fellowship application; however, he underscored the fact that there were not enough funds to pay me a salary. However, that did not dissuade me from accepting the position.

14 TRANSPLANTATION IN TURKEY Transplantation

On January 1, 1974, I left Galveston and went to Denver. (And incidentally, after my third month in Denver, they were able to create a fund with which to pay me a modest sum). For a year and a half, until June 30, 1975, I worked in Denver, during which time I learned many things related to experimental and clinical kidney and liver 15 transplantation. TRANSPLANTATION IN TURKEY Transplantation

Heterotopic Heart Transplantation in Rats

16 TRANSPLANTATION IN TURKEY Transplantation

17 TRANSPLANTATION IN TURKEY Transplantation

the acceptance of my department, alone, was not going to be enough, I had to convince the members of other departments (those that were related to transplantation) as well. I knocked on nearly every door at the University. To convince them that a transplantation program was much needed, I made a detailed presentation about my Prof. Dr. Ihsan Dogramaci & Bilkent University activities in Denver.

I returned to Turkey on June 30, 1975, and renal transplantations as quickly as possible. Finally, I visited Professor Coruh, who is at that time, no work or innovative Because, in my country, many people were here with me now. At the time, he was processes were being done in the field of dying of chronic kidney and liver diseases Director of the Institute of Population Studies transplantation. There had been the creation that could have been treated with at Hacettepe University. I talked to him of a few dialysis centers but nothing more. A transplantation. about how I saw the situation, and he took beginning had to be made. me to Professor Ihsan Dogramaci, Founder With the chairman of the department of and President of Hacettepe University, later, My first goal, then, was to establish a burn general surgery and all members of the he also founded Bilkent University. unit and a transplantation unit at Hacettepe staff, I discussed my ideas of launching a University Hospitals and to begin performing kidney transplantation program. And since TRANSPLANTATION IN TURKEY Transplantation

First Renal Transplantation in Turkey, from Mother to Son, Hacettepe University, November 3, 1975

Professor Dogramaci appointed me To prepare for our first attempts at renal ultimately, for clinical transplantation, were Consultant of Pediatric Nephrology. This transplantation in human patients, I successful. And when our team was ready, step was crucial, because now, with that organized a surgical team. We began by we performed the first human renal simple appointment, nearly 50% of my performing experimental kidney transplantation in Turkey with a kidney problems were solved. transplantations on dogs first, since no one donated from a mother to a 12-year-old son on the team was familiar with on November 3, 1975. transplantations except me, and this is where the bulk of my training had been. Those first trials, which prepared our team, TRANSPLANTATION IN TURKEY Transplantation

Establishment of New Transplantation Units

It is interesting to note that there was no With this transplantation, the doors for room in which to hospitalize the transplanted transplantation in Turkey opened wide. From patient, and I was forced to bring the boy to this point forward, we could establish new a store room in which there were only 2 transplantation units as we saw fit. beds-one for the patient, and one for me. What's more, no other person on the staff had the training necessary to care for the boy, and so, I had to take care of his postoperative course personally. TRANSPLANTATION IN TURKEY Transplantation

First Cadaveric Kidney Transplantation with the Organ Supplied by Eurotransplant, Hacettepe University, October 10, 1978

Our next goal was to perform the first cadaveric kidney transplantation at our center, and on October 10, 1978, using an organ supplied by the Eurotransplant International Foundation, we did. At the same time, I contacted the South Eastern Organ Procurement Foundation to begin a relationship with them, and they began to send cadaver kidneys as well. TRANSPLANTATION IN TURKEY Transplantation

First Local Cadaveric Kidney Transplantation, Hacettepe University, July 27, 1979

On July 27, 1979, our team performed the first local cadaveric kidney transplantation at our center. TRANSPLANTATION IN TURKEY Transplantation

First Successful Cadaver Liver Transplantation in Turkey, in the Middle East, and in Northern Africa, Turkish Transplantation & Burn Foundation Hospital, December 8, 1988

In addition to kidney transplantations, our team also performed:

In December 8, 1988, the first successful cadaver liver transplantation in Turkey, in the Middle East, and in Northern Africa, and TRANSPLANTATION IN TURKEY Transplantation

First Organ Harvesting and Sharing Programs in Different Cities of Turkey, 1989

In 1989, our team also launched the first organ harvesting and sharing programs in different cities of Turkey. TRANSPLANTATION IN TURKEY Transplantation

First Pediatric Segmental Living-related Liver Transplantation, in Turkey, in the Region, and in Europe, Turkish Transplantation & Burn Foundation Hospital, March, 1990

These were followed by:

The first pediatric segmental living- related liver transplantation in Turkey, the region, and in Europe in March 1990. TRANSPLANTATION IN TURKEY Transplantation

First Adult Segmental Living-related Liver Transplantation in the World, Turkish Transplantation & Burn Foundation Hospital, April 1990

The first adult segmental living-related liver transplantation in the world in April, 1990. TRANSPLANTATION IN TURKEY Transplantation

Publications on the First Adult Segmental Living-related Liver Transplantation and the First Pediatric Segmental Living-related Liver Transplantation

27 TRANSPLANTATION IN TURKEY Transplantation

First Combined Liver-Kidney Transplantation from Living-related Donor, first operation of its kind, Turkish Transplantation & Burn Foundation Hospital, May 1992

And in May 1992, the first combined liver-kidney transplantation from a living- related donor, which was the first operation of its kind performed anywhere in the world. TRANSPLANTATION IN TURKEY Transplantation

Organ/Tissue Transplantation Centers Regions According to National Coordination in Turkey Center

In 2001, our country's Health Ministry procurement is a great idea in theory-as is gathered all related resources together the case in many other countries-there are under one umbrella organization, the plenty of patients but not enough organs. National Coordination Center, the aim of which is to promote transplantation activities, especially cadaver organ procurement. It still must be mentioned, however, that although cadaveric organ TRANSPLANTATION IN TURKEY Transplantation

30 TRANSPLANTATION IN TURKEY Transplantation

Total Number of Hemodialysis Centers : 494 Total Number of Peritoneal Dialysis Centers : 115

Today in Turkey, there are more than 30 experience (particularly within the last 2 with regard to kidney, liver, heart, kidney- transplantation centers (heart decades), combined with advances in high- pancreas, cornea, bone marrow, and a few transplantation in 12 centers, liver technology equipment and specialized heart and lung transplantations. transplantation in 13 centers, kidney teams of physicians, as well as the transplantation in 23 centers, cornea increasing number of hemodialysis and In addition, throughout Turkey, total number transplantation in 23 centers, bone marrow peritoneal dialysis units, has enabled of hemodialysis centers is 494; peritoneal transplantation in 15 centers). The ever- transplant patients in Turkey to receive the dialysis center is 115. increasing amount of knowledge and most advanced care possible, especially TRANSPLANTATION IN TURKEY Transplantation

32 TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Legislation and Organ Donation

33 TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Effective and Safe Use of Cadaveric Organs from Eurotransplant and South Eastern Organ Procurement Foundation

As I mentioned earlier, when I returned to no transplantation infrastructure. the only option for transplant candidates on Turkey in 1975, very few people were aware waiting lists in Turkey was to receive a graft of transplantations, especially kidney When I started transplantation, no legislation from a first-degree living-related donor. transplantations. At the time, those with was in existence regarding transplantation, Again, there were plenty of patients but not some understanding of transplantations and therefore, any transplantations that enough organs. were going to Europe or the United States were performed were done simply by written for their surgeries. In Turkey, we simply had consent of the donor and the recipient. Also, TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Drs. Bernard Cohen and Guido Persijn, Eurotransplant Administrators

Mr. Gene Pierce, South Eastern Organ Procurement Foundation Administrator

We were forced use cadaveric organs, and organs, simply turn to ashes after the cooperation of Eurotransplant it was up to me to prove that we could use person's death. That is why, to make more Administrators, Drs. Bernard Cohen and cadaveric organs safely and effectively. I cadaveric organs available to Turkish Guido Persijn, and South Eastern Organ had to persuade the public at large that patients, I contacted Eurotransplant and the Procurement Foundation Administrator, organs transplantations could help sick South Eastern Organ Procurement Gene Pierce. persons to get well, and also, I wanted to Foundation, both which are responsible for point out the terrible waste there was in the mediation and allocation of organ having perfectly viable, transplantable donations. I will always appreciate the TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Cadaveric Kidney Transplantations with Cold Ischemia Time over 100 Hours

With the organs they supplied, many foundations were not "normal" cadaver than 100 hours. In fact, one of my important and successful cadaver kidney kidneys; they generally came to us after patients is still alive today, with a kidney transplantations followed. Even the having undergone more than 24 hours' transplanted in her, in 1983, after a cold kidneys transplanted with long cold cold ischemia. They were anatomically ischemia time of 111hours, 54 minutes. ischemia times functioned great. problematic as well. However, these Her case proved that it is possible to keep kidneys were used with a high success a harvested kidney viable at +4ºC for I should also emphasize that the organs rate. With these transplantations, we more than 100 hours. supplied by organ procurement increased the cold ischemia time to more TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Works with Turkish Parliament

This was a major achievement. people say, "Dr. Haberal brings kidneys Unfortunately, however, I was criticized by back from the grave." Even today, I then began working with government colleagues, both in my country and around classical medical books continue to indicate authorities, trying to raise public awareness the world, for using kidneys with a maximum acceptable cold ischemia time about the benefits of cadaver transplantation "excessively long" ischemia times. It for kidneys of 72 hours. and the related challenges that face health became common at conferences to hear professionals. TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Board of Religious Affairs & Publishing Media

In addition, I worked with the Board of Religious Affairs and charity organizations, such as the Lions and Rotarians, and various groups in the publishing media. TRANSPLANTATION IN TURKEY Legislation and Organ Donation

I began to make guest appearances on following their surgeries. Through our use of television and radio programs together with the media, we attempted to persuade our my transplanted patients. We explained to Parliament, officials in the Department of the people, "What is a transplantation? and Religious Affairs, the Ministry of Health, and What is an organ donation? and Why is it those in other governmental institutions that necessary?" By doing this, the people we transplantation was a life-saving procedure. spoke to were able to see that the transplanted people were healthy and well TRANSPLANTATION IN TURKEY Legislation and Organ Donation

But still, some of the religious leaders would be as if he saved the life of the accused me of interfering with God's whole people. Then although there work. Finally, the Chairman of the Board came to them Our apostles with clear of Religious Affairs explained that neither signs, yet, even after that, many of transplantation nor organ donation was them continued to commit excesses in against Muslim belief, referring to a sura the land.' from the Quran, sura Al-Maidah, Verse 40 32 (35 in some books), which says: 'On And by emphasizing especially the point, that account: We ordained for the "Only the person to whom one donates Children of Israel that if any one slew a one of his/her organs oneself is person - unless it be for murder or for responsible for all his/her good and spreading mischief in the land - it evil deeds," the Board of Religious would be as if he slew the whole Affairs published: people: and if any one saved a life, it TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Republic of Turkey, the Supreme Board of Religious Affairs

The Supreme Board of Religious Affairs stated by its decision dated March 6th, 1980/396, that organ transplantation is lawful. According to this decision organ transplantation may only be performed under the following conditions:

1- Under necessity: that is, when a medical doctor, whose professional efficiency and integrity is respected, states that organ transplantation is the only way to save a patient’s life or one of his vital organs. 41 2- When the medical doctor is of the prevailing opinion that organ transplantation is the only way to cure the disease. 3- When it is certain that the person whose organ or tissue to be removed is dead. 4- When the patient who will receive a transplanted organ gives this consent to the operation.

Only the person to whom one donates one of his/her organs oneself is responsible for all his/her good and evil deeds. TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Finally, following all those efforts, on June 3, 1979, legislation on harvesting, storing, grafting, and transplanting organs and tissues was passed in the Parliament, and in fact, has been deemed progressive enough to be used as a model by many other countries.

Turkish Transplantation Law # 2238

On the Harvesting, Storage, Grafting and ARTICLE 6- In order to be able to harvest ARTICLE 12- The physician who will Transplantation of Organs and Tissues organs and tissues from any person over perform the transplant surgery cannot be (June 3, 1979) the age of 18 who is of sound mind, a among the group which pronounced the protocol, which beforehand the donor has donor as dead (Article 11), 42 ARTICLE 3- The buying and selling of approved of in writing and subscribed to ARTICLE 15- Those harvesting, storing, organs and tissues for a monetary sum verbally before at least two witnesses, grafting and transplanting organs and or other gain is forbidden. should be approved by a physician. tissues in a manner not conforming to ARTICLE 4- Except for the distribution of ARTICLE 11- In connection with this law, and those intermediating in information having scientific, statistical, and enforcement of this law, the case of such actions as the buying and selling of new characteristics, all advertisement in medical death is established organs and tissues and those brokering connection with the harvesting and unanimously by a committee of 4 same, in the case that it does not require donation of organs and tissues is physicians consisting of 1 cardiologist, 1 any heavier punishment, shall be sentenced forbidden. neurologist, 1 neurosurgeon, and 1 to punishment of two (2) to four (4) years, ARTICLE 5- Harvesting organs and anesthesiologist by applying the rules, and of 50,000 to 100,000 Turkish Lira. tissues from persons under the age of 18 methods and practices which the level of or who are not of sound mind is science has reached in the country. forbidden. TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Board of Religious Affairs Continues to Inform People via Media on Organ Donation and Transplantation

I am forever grateful for the contributions of Today, the Board of Religious Affairs the members of the Parliament; the persons continues to inform people (especially in the print media, television, and radio; during Friday prayers, which is a holy day those in the Board of Religious Affairs; and according to Muslim belief), and via media many, many other people. They were our of all the benefits of transplantation. main supporters in getting this law enacted and they still are. TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Organ Donation Campaigns

Following this, we had standardized "Organ Again, through the media, I presented Donation Cards" printed as well. Our aim information on where persons could obtain with this project was to promote donation these cards, and that they should keep and raise people's consciousness about those cards with them (in their wallets, for transplantation. We still organize organ example) so that physicians would know donation campaigns at the exits of the immediately, in the case of death, that their mosques as well. organs were available for donation. TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Organ Donation Campaigns

45 TRANSPLANTATION IN TURKEY Legislation and Organ Donation

Even after passage of the legislation and increasing the number of facilities, we still saw, a few years later, that the organs supplied via the different media were still not enough. Unfortunately, thousands of people in Turkey were dying in car accidents, and again, perfectly viable organs were being lost, and my feeling was that the deaths of these people should not be in vain, but in LAW 2238 AND 2594 On the fact, they still were. harvesting, storage, grafting and transplantation of organs and tissues Therefore, in 1982, I applied again to the government, and the law on organ and Unfortunately, tissue transplantation was amended to state thousands of people LAW No. 2594 ADDENDUM that after a car accident or natural disaster, if in Turkey were dying (January 21, 1982) the relatives of a deceased person could not be found, then the organs of the deceased in traffic accidents, ARTICLE 4 - In the event of any accident 46 person could be harvested without having to and the deaths of or natural death, provided that the cause of obtain permission. death is not in any way related to the reason these people should for organ harvesting and according to the Today, still, transplantations are performed not be in vain conditions stated in Article 11, the suitable according to this law, and any kind of activity organs and tissues can be transplanted into against this law ends with severe persons whose lives depend upon this punishment of the perpetrators. Especially, procedure without permission from the article number 15 of the Law number 2238 next of kin. addresses this, as follows: "Those harvesting, storing, grafting and transplanting organs and tissues in a manner not conforming to this law, and those intermediating in such actions as the buying and selling of organs and tissues and those brokering same, in the case that it does not require any heavier punishment, shall be sentenced to punishment of two (2) to four (4) years, and of 50,000 to 100,000 Turkish Lira." Facilities, Societies & Scientific Activitie

47 TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Organ Transplantation and Burn Foundation, September 4, 1980

A. There were plenty of patients but not enough facilities for both transplantation and dialysis. Many patients from different cities in Turkey were coming to our center from As I mentioned earlier, when we began kilometers away for transplantation transplantation at Hacettepe University, the and dialysis. 48 conditions were so limited that we could hardly establish a unit. Dialysis conditions B. I realized that some of our transplant were limited either. There were two main recipients were very poor and could not problems during those days: afford the medicines required. In contrast, the wealthier kidney recipients, with enough financial means, did fine. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Recognizing this inequity, I decided to establish a fund to support patients in need, and I established the Turkish Organ Transplantation and Burn Foundation on September 4, 1980.

The Foundation's aim was, and still is, to support poor patients so they can 49 afford their medication, to provide financial help, to promote organ donation, to organize training programs, to create a medium for international collaboration and scientific activities, and opening new dialysis and transplantation centers. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

First Hemodialysis Center, Baskent University Hospital, Ankara, March 12, 1982 Ankara, March 2006

50 19822006

Through the Turkish Organ Transplantation and Burn Foundation, I established the first hemodialysis center in Ankara on March 12, 1982. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Organ Transplantation & Burn Baskent University Hospital, Foundation Hospital, Ankara, 1985 Ankara, March 2006

After we opened the first hemodialysis At the same time, dialysis and In 1985, I opened the Turkish Organ center, many patients from outside the city transplantation centers were gradually being Transplantation and Burn Foundation came, and this was very difficult for them. I opened at several universities throughout Hospital in Ankara. This was the first therefore decided to expand facilities Turkey. The Ministry of Health and the hospital in our country to specialize in outside Ankara to bring this service to other Ministry of Labor's activities in this way transplantation. After opening this hospital, I big cities such as Istanbul, Adana, and increased. began performing transplantations both at Izmir. Hacettepe University Hospital and at this new hospital. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Baskent University Campus Orchestra Academic Baskent Channel B

To develop education and healthcare in my Realizing the fact that public and health country, I founded the Haberal Educational awareness is a matter of education, in 1993 Foundation in 1986. I decided to establish Baskent University under the aegis of the Turkish Organ In 1992, the Turkish Organ Transplantation and Burn Foundation, and Transplantation and Burn Foundation the Haberal Educational Foundation. Hospital was certified as a training hospital by the Ministry of Health. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Today, including a faculty of medicine, the level, 8 hospitals (all with dialysis centers), University comprises 11 other faculties, 7 and 6 additional independent dialysis institutes (including a transplantation and centers. The various healthcare facilities are genetic sciences institute), 3 vocational located in cities throughout the country and schools, 1 preparatory school, 2 colleges are governed from the central hospital in that begin education at the nursery school Ankara and a liaison office in Munich, level and continue through the university Germany. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Baskent University Experimental Animal Breeding Center

In addition, Baskent University owns and and guinea pigs);a large agricultural farm; a operates 2 luxury hotels (1 is a spa with cow farm; a quail farm; a bee farm; a textile baths); 2 holdings; more than 20 companies; workshop; a work clothes shop; a dialysis the Baskent University Transplantation and solution factory; a gas station; a Genetic Sciences Institute Integrated woodworking shop; and an ironworks. Facilities, which includes a milk production factory; an experimental animal breeding center (with pigs, rats, rabbits, hamsters, Healthcare, Education, Tourism and Other Facilities

1. BAŞKENT UNIVERSITY CAMPUS 1. BAŞKENT UNIVERSITY ANKARA HOSPITAL 8. İSKENDERUN DIALYSIS CENTER 2. CHANNEL B 2. ADANA TEACHING & MEDICAL RESEARCH 9. İSTANBUL DIALYSIS CENTER 3. PATALYA LAKESIDE HOTEL CENTER 10. ŞANLIURFA DIALYSIS CENTER 4. PATALYA THERMAL RESORT HOTEL 3. SEYHAN TEACHING & MEDICAL RESEARCH 11. YENİKENT DIALYSIS CENTER 5. ANKARA COLLEGE CENTER 12. ZİLE DIALYSIS CENTER 6. BAŞKENT PRIMARY AND 4. ALANYA TEACHING & MEDICAL RESEARCH 13. YAPRACIK PSYCHOSOCIAL SECONDARY SCHOOLS CENTER REHABILITATION CENTER 5. ZÜBEYDE HANIM TEACHING & MEDICAL 14. AYAŞ PHYSICAL THERAPY & RESEARCH CENTER REHABILITATION CENTER 6. KONYA TEACHING & MEDICAL RESEARCH 15. AÇKAR MILK PRODUCTS CENTER 16.BASKENT GROUP HEALTH PRODUCTS 7. ELMALIK DIALYSIS CENTER TRADE and INDUSTRY INC. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Quality System Certificates in Education and Hospital Systems, International Standards Organization

The University also operates a television channel, Channel B, Radio Baskent, and the Baskent News Agency that airs informational and educational programming. All of our educational and hospital systems have received a quality system certificate from the International Standards Organization (ISO). TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

The University has a current annual operating budget of more than USD $300 million and employs more than 8000 people. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Dialysis and Middle East Dialysis and Transplantation Society, Organ Transplantation 1980 Foundation, 1984

In 1980, I established the Turkish Dialysis and in 1984, I established the Middle East and Transplantation Society, Dialysis and Organ Transplantation Foundation (MEDOTF) to facilitate organ sharing and procurement in the Middle East. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Middle East Society for Organ Transplantation (MESOT), 1987

This was followed by establishing the Middle East Society for Organ Transplantation (MESOT) in 1987 under the leadership of our team, which has continued to carry out its mission despite the international problems in this region.

MESOT member nations have dealt with 59 and continue to tackle a range of transplantation-related problems in countries that share similar sociocultural characteristics. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Transplantation Society, 1990

1990, the Turkish Transplantation Society was established.

Both societies are affiliated with the International Transplantation Society. Since the founding of MESOT, we have organized congresses every 2 years and 60 have held these in different Middle Eastern countries. Every 2 years, since its inception, with great commitment and enthusiasm, the Turkish Transplantation Society, from members and organizers alike, has held 8 international scientific congresses to date. TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Transplantation Meeting, 1983, Ankara

61 TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Transplantation Society Meeting, Award Ceremony, 2001, First Felix T Rapaport Memorial Award

62 TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Transplantation Society Meeting, 2003

63 TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Turkish Transplantation Society Meeting, Award Ceremony, 2005

64 TRANSPLANTATION IN TURKEY Facilities, Societies and Scientific Activities

Proceedings of all MESOT and Turkish and in Experimental and Clinical Transplantation Society meetings have been Transplantation, the official journal of the published in the journal, Transplantation MESOT, which is currently indexed by Proceedings. MEDLINE/PubMed and EMBASE.

Additionally, all transplantation activities are being published in:

Dialysis, Transplantation and Burn, the official journal of the Turkish Transplantation Society, TRANSPLANTATION IN TURKEY Transplantation

Summary

Today, in Turkey, kidney, liver, heart, A. Legislation has enabled enough facilities Dialysis, Transplantation and Burn, the kidney-pancreas, cornea, bone marrow, and for organ donation and prohibited organ official journal of the Turkish Transplantation a few heart and lung transplantations are selling and advertisement. Society, Experimental and Clinical performed in more than 30 transplantation Transplantation, the official journal of centers (heart transplantation in 12 centers, B. Despite modern legislation and active MESOT, which is currently indexed by liver transplantation in 13 centers, kidney educational programming, still, 75% of MEDLINE/PubMed and EMBASE, and transplantation in 23 centers, cornea kidney and liver transplantation is Transplantation Proceedings, the official 66 transplantation in 23 centers, bone marrow performed from living donors journal of the International Transplantation transplantation in 15 centers) with enough (first/second degree relatives and Society. facilities for transplantation as well as spouses) and only 25% is from hemodialysis and peritoneal dialysis. cadavers. This is the history of transplantation in Currently there are 494 hemodialysis Turkey, from 1975 to 2006. centers, and 115 peritoneal dialysis center. C. Scientific activities continue through the Turkish Transplantation Society and MESOT and indirectly, through the International Transplantation Society.

D. Transplantation activities are being published in: 67 www.baskent.edu.tr