Renal transplantation is considered as a more desirable treatment option for patients who need renal replacement therapy (RRT) and is universally practised all around the world. There are various side effects of renal transplantation, but compared to dialysis, the survival of patients is comparatively better than the dialysis population. [1][2][3] According to World Health Organization (WHO), there are 91 countries where renal transplants are carried out. Around 66,000 kidney transplants, 21,000 liver transplants, and 6,000 heart transplants were performed globally in 2005. Although, transplantation offers the leading option for end stage renal disease (ESRD) patients, many of them do not have an opportunity for this type of treatment, mainly because of lack of organ supply.The shortage of organs is virtually a universal problem. In some countries, the development of a deceased organ donation programme is delayed due to legal, sociocultural and other factors. The use of living donors for kidney and liver transplantation is also practised, but the purchase and sale of transplant organs from live donors are prohibited in many countries. 4 The shortage of an indigenous supply of organs has led to the development of the international organ trade, where potential recipients travel abroad to obtain the organs. In western countries, deceased organ donation has reached to a steady state thus a number of ESRD patients on transplant are on the waiting list and the list is increasing progressively day-by-day. 5 Many ESRD patients, who do not have availability of living related donors, opt for other donor sources, including LURRT and considered it as the final option. Besides this, since many patients cannot find appropriate unrelated donors in their own countries due to multiple reasons (social, ethical and legal), they travel to other countries, mostly Third World, for their transplant, which also means commercial or paid transplantation, which is not always ethical. [6][7][8][9][10] In 1987, the 40th World Health Assembly, due to the increased trade of human organs, initiated the preparation of the first WHO Guiding Principles on