About IMAM REZA Hospital Complex

The educational and therapeutic center of Imam Reza Hospital, equipped with 800 beds, 24 active clinical wards, 100 special care beds, and 20 operating rooms.

Golestan Burn Center, as the only burn center located in western Iran, with 50 beds, operating rooms, and BICU beds.

The five-story comprehensive care clinic of Boostan with 60 specialized and subspecialized offices.

The center for multidrug-resistant TB, and
The all-inclusive cancer center with 120 beds and chemotherapy departments as well as its world-class high-tech radiotherapy equipment.

Among the other distinguishing features of this well-appointed hospital complex is its enjoyment of the first-over bone marrow transplantation and peripheral blood stem cell transplantation establishment in western Iran ,provision of a wide range of advanced imaging services ,including MRI, and nuclear medicine using the most up-to-dale MRI,CT Scan and angiography machines, and performing advanced surgeries such as urodynamic tests, PCNL, female pelvic laparoscopy, and laparoscopic urological surgeries, etc.

 
This renowned hospital also caters for patients through its renal transplant department , special care units of acute ischemic stroke , high-risk pregnancy department ,isolated respiratory rooms, and international patient department.

 
Last but not least, a proper groundwork has been provided for teaching medicine at Imam Reza Hospital Complex through getting full benefit from the largest center for clinical skills in western Iran and its 200 well-versed specialist and subspecialist as well as its enjoyment of diverse facilities , thereby pushing the boundaries of possibilities in this respect.

KURDISTAN–KERMANSHAH INTERNATIONAL BONE MARROW TRANSPLANT REFERRAL NETWORK

A Strategic Proposal for the Referral, Transfer, and Management of Patients Requiring Hematopoietic Stem Cell Transplantation (HSCT) from the Kurdistan Region of Iraq to Kermanshah, Iran
1. Introduction
The Kurdistan Region of Iraq has a growing need for specialized hematology and hematopoietic stem cell transplantation (HSCT) services. Establishing an organized referral pathway between hematology centers in the Kurdistan Region and the Bone Marrow Transplantation Center in Kermanshah, Iran, could improve patient access to advanced cellular therapies.
Kermanshah, due to its geographical proximity to the Kurdistan Region, offers an opportunity to develop a regional medical referral network that facilitates timely diagnosis, transplantation, and post-transplant follow-up.
The proposed initiative aims to establish a structured clinical, administrative, and logistical pathway for referring patients from Erbil, Sulaymaniyah, Duhok, Halabja, and surrounding areas to the Bone Marrow Transplantation Center at Imam Reza Hospital, Kermanshah University of Medical Sciences.
2. Destination Center
Bone Marrow Transplantation Center
Imam Reza Hospital
Kermanshah University of Medical Sciences
Kermanshah, Iran
The center will serve as the principal destination for the evaluation and management of patients requiring hematopoietic stem cell transplantation.
The proposed referral program will cover the following indications:
* Acute Myeloid Leukemia (AML)
* Acute Lymphoblastic Leukemia (ALL)
* Myelodysplastic Syndromes (MDS)
* Aplastic Anemia
* Hodgkin and Non-Hodgkin Lymphomas
* Multiple Myeloma
* Other selected hematological disorders requiring HSCT
The transplantation options will include:
* Autologous HSCT
* Allogeneic HSCT
* Haploidentical HSCT
The final transplantation strategy will depend on the patient’s diagnosis, disease status, donor availability, and clinical eligibility.
3. Geographical Referral Routes
Three major referral areas are proposed:
Referral Region
Proposed Border Crossing
Destination
Sulaymaniyah
Bashmaq – Marivan
Kermanshah
Halabja
Bashmaq – Marivan
Kermanshah
Erbil and surrounding areas
Parviz Khan – Qasr-e Shirin
Kermanshah
Garmian Region
Parviz Khan – Qasr-e Shirin
Kermanshah
Duhok
Route determined according to border accessibility and patient condition
The final transportation route will be selected according to the patient’s location, border regulations, travel time, and medical condition.
4. Proposed Clinical Referral Pathway
The referral process will consist of six major stages.
Stage 1: Patient Identification and Initial Evaluation
Hematologists and oncologists in the Kurdistan Region will identify patients who may benefit from HSCT.
Participating referral centers may include hospitals and hematology clinics in:
* Erbil
* Sulaymaniyah
* Duhok
* Halabja
Stage 2: Medical Documentation and Referral
The referring physician will prepare and submit a standardized medical report to the Kermanshah Transplantation Center.
The required documentation will include:
* Definitive diagnosis and histopathology
* Bone marrow aspiration and biopsy
* Flow cytometry
* Cytogenetic and molecular studies
* Minimal Residual Disease (MRD) status
* Disease status (CR1, CR2, refractory disease, or relapse)
* HLA typing of the patient and potential donor
* Previous chemotherapy and treatment history
* Assessment of cardiac, pulmonary, hepatic, and renal function
* Performance status and infectious disease screening
Stage 3: Multidisciplinary Transplant Evaluation
The transplantation team in Kermanshah will review each referral.
The evaluation will determine:
* HSCT eligibility
* Appropriate transplantation modality
* Donor selection
* Conditioning regimen
* Required pre-transplant investigations
* Estimated treatment costs
* Proposed admission date
A multidisciplinary committee may be established to review complex cases.
Stage 4: Administrative Coordination and Patient Transfer
Following medical acceptance, the international patient coordination office will arrange:
* Official admission and acceptance letters
* Travel and border-crossing documentation
* Medical transportation arrangements
* Accommodation for patients and accompanying family members
* Admission scheduling
* Financial and insurance coordination
Stage 5: Transplantation and Inpatient Management
Patients will undergo the necessary pre-transplant preparation, conditioning chemotherapy, stem cell infusion, and post-transplant supportive care.
The transplantation team will provide:
* Conditioning chemotherapy
* Stem cell infusion
* Infection prevention and management
* GVHD prophylaxis and treatment
* Blood product support
* Engraftment monitoring
* Management of transplantation-related complications
Stage 6: Discharge and Long-Term Follow-up
Following clinical stabilization and discharge, patients may return to the Kurdistan Region under a coordinated follow-up program.
The follow-up protocol will include:
* Complete blood count monitoring
* Chimerism analysis
* MRD assessment when indicated
* Graft-versus-host disease (GVHD) monitoring
* Infectious disease surveillance
* Immunosuppressive medication monitoring
* Assessment of late transplantation complications
Follow-up will be coordinated between the Kermanshah transplant team and the referring hematologist in Iraq.
5. Organizational Structure of the Referral Network
A dedicated organizational structure is recommended to ensure efficient coordination.
Department
Main Responsibilities
BMT Program Director – Kermanshah
Clinical leadership and transplantation decisions
International Patient Coordinator
International admissions and administrative coordination
Kurdistan Referral Coordinator
Communication with referring physicians and hospitals
HLA Laboratory
Histocompatibility testing and donor evaluation
Medical Transportation Unit
Coordination of patient transportation
Financial Coordination Unit
Cost estimation and financial arrangements
Post-Transplant Follow-up Team
Long-term monitoring and continuity of care
6. Medical Transportation and Patient Safety
Patient transportation must be determined according to clinical stability and the level of medical support required.
Patient Condition
Recommended Transportation
Clinically stable, without active infection or bleeding
Commercial transportation or private vehicle, following medical clearance
Severe neutropenia or need for close monitoring
Equipped medical ambulance when clinically indicated
Febrile neutropenia or active infection
Initial stabilization and treatment before transfer, unless urgent transfer is specifically arranged
Hemodynamic instability or active bleeding
Advanced life-support ambulance or air medical transfer, depending on urgency and availability
Severe post-transplant complications
Specialized medical transportation following coordination between both centers
Medical clearance must be obtained before transportation. Appropriate infection-control precautions and continuity of treatment are essential.
7. Strategic Development of the Program
Rather than establishing only a patient transfer system, this initiative could develop into a broader regional medical cooperation program.
Proposed Program Title:
Kermanshah International Hematopoietic Stem Cell Transplantation Program
Strategic Objectives:
1. Facilitate access to advanced HSCT services for patients from the Kurdistan Region of Iraq.
2. Establish direct professional communication with hematologists in Erbil, Sulaymaniyah, Duhok, and Halabja.
3. Develop a joint multidisciplinary transplant referral committee.
4. Establish standardized clinical and administrative referral procedures.
5. Provide access to autologous, allogeneic, and haploidentical transplantation.
6. Develop a structured post-transplant follow-up network.
7. Promote scientific collaboration, clinical research, and professional education between participating institutions.
8. Initial Implementation Plan
Three initial actions are recommended:
1. Institutional Cooperation Agreement
Develop a Memorandum of Understanding (MOU) between the Kermanshah Transplantation Center and selected hospitals and hematology institutions in the Kurdistan Region.
2. Establishment of a Referral Coordination System
Appoint designated physicians in Erbil, Sulaymaniyah, and Duhok, together with a central referral coordinator in Kermanshah.
3. Standardized Referral Documentation
Develop standardized English-language referral forms, including clinical information, transplantation eligibility criteria, donor assessment, and pre-transplant investigations. Kurdish-language versions may also be prepared to facilitate communication.
9. Expected Outcomes
The implementation of this program is expected to:
* Improve access to specialized transplantation services.
* Reduce delays in referral and transplantation.
* Strengthen regional medical cooperation.
* Improve continuity of care before and after transplantation.
* Facilitate academic and research collaboration.
* Establish Kermanshah as a potential regional referral destination for HSCT.
10. Conclusion
The establishment of the Kurdistan–Kermanshah International Bone Marrow Transplant Referral Network represents an opportunity to strengthen cross-border medical cooperation and expand access to advanced hematological treatments.
Through institutional partnerships, standardized referral protocols, coordinated patient transportation, and structured post-transplant follow-up, the program could provide a sustainable model for regional cooperation in hematopoietic stem cell transplantation.
The ultimate goal is to establish Kermanshah as an accessible and reliable transplantation destination for eligible patients from the Kurdistan Region of Iraq.
Recommended next step: This document can be developed into a formal institutional proposal addressed to the President of Kermanshah University of Medical Sciences and the directors of major hospitals in Erbil and Sulaymaniyah, including an implementation timeline, financial framework, and draft MOU.

Imam Reza Hospital Complex
The Largest, Most Modern and Well-appointed Hospital in
western and Northern Iran