This document outlines the key considerations for setting up a renal transplant program in a developing country. It discusses the challenges such as lack of infrastructure, political will, and cost concerns. It recommends starting with living donation and engaging an experienced transplant center for skill transfer. It also addresses the requirements for deceased donation, including legal frameworks, ethics committees, ICU support, and training transplant clinicians. The basic requirements listed are political and economic support, legal frameworks, independent ethics, national databases, validated allocation systems, and trained transplant teams.