For Zahra Hajikarimi, organ donation offers a chance to leave dialysis behind. The machine cleans her blood, three times a week and each treatment takes four hours.
"It would be very difficult to imagine life without the possibility of a kidney donation," Ms Hajikarimi told APTN.
"It is very difficult, for even one moment to imagine that there is no cure and you have to live with this disease until the very last moment of your life."
Under the Iranian scheme, potential recipients register with the patient-run Dialysis and Transplant Patients Association.
It matches those in need with a healthy adult donor up to 45-years-old.
The Patients' Association receives no money for brokering the exchange, however they help negotiate financial compensation for the donor.
In Iran, a kidney typically costs 135 million rials - around AU$6,000.
Hashem Ghassemi, head of the Kidney Foundation of Iran, told APTN organ donation was almost unheard of before the program was introduced in 1988.
"In Iran there were no kidney transplants in the past and patients had no choice but to spend a lot of time and go abroad to wait on a waiting list for a year or two to get a kidney from a deceased person.
"But now, praise to Allah, this problem has been solved in our country."
Head of the Kidney Transplant Department at Modarres hospital in Tehran, Majid Ali Asgari, told APTN the Iranian government finances the surgery and related ongoing health costs for one year.
"It is a financial problem that makes one do this."
"Since the very beginning there has been no financial links between us and the patients. Absolutely nothing. Transplants have been free of charge in Iran since the beginning, although they are very costly."
Live donors now account for the vast majority of kidney transplants in Iran. The transplant waiting list was eliminated in 1999, according to Iranian officials.
In Australia, the waiting time for a kidney transplant is about three years. Although, living transplants are up 19 per cent in the year to date.
This increase follows the introduction of a scheme which reimburses employers for up to nine weeks of leave taken by the donor, as well as a donor exchange program.
Living transplants are preferable because surgery can be planned, reducing time between removal and transplantation and thereby improving outcomes.
Professor Jonathan Craig is on the board of Kidney Health Australia. He told SBS most living donors give to improve the lives of their loved ones.
"Living with kidney failure is a really unpleasant experience and most of the people who donate are family members and close friends - so they know what life is like on dialysis."
Financial incentive to donate
While many Iranian donors claim their motives are purely altruistic, there are those who admit to financial pressures.
One donor, who spoke on the condition of anonymity, told APTN he felt he had no other choice.
"The reason I had to sell my kidney was that my life would have competely fallen apart if I didn't do that. I would have lost my life, my wife, my child.
"One is really happy to be able to save a human being's life, I mean it, it's a good feeling. But it is a financial problem that makes one do this."
Some ethicists and doctors argue that compensating donors puts the poor under pressure to donate, while patients lacking funds are less likely to receive a transplant - with organs often going to the highest bidder.
Professor Jonathan Craig said commercial transplants have no place in the Australian health care system.
"Sure we want to improve the lives of people on dialysis, but we actually have to protect the lives of vulnerable people. A commercial process that does occur in some parts of the world I think would never occur in Australia. It's unjust and it's wrong."
Tehran resident Reza Niayesh told APTN the economic sitiuation in his country, gripped by sanctions, is driving people to take great risks.
"A friend of mine recently needed a kidney and he paid a lot of money and agreed to pay even more to the donor. But a couple of days ago, the donor texted him and said he wouldn't sell his kidney.
"I asked him to come and sign up at the Kidney Foundation and it is much better. Yes, you are added to a waiting list but it is better for donors and receivers."
Some argue regulated, commercial donations would also go some way to combating the burgeoning black market in kidneys, in countries such as India, the Philippines and Pakistan.
As Zahra's dialysis session ended she said, for her, commercial donation makes sense.
"It would have been a total mess. Trafficking is a negative thing everywhere. How do you control it? There would be no supervision without the current system.
"You wouldn't know from whom you were receiving a kidney, you wouldn't know if they were healthy and if they were suitable. In such a situation one would rather not go through a transplant at all."
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