The Lancet Regional Health. Americas (Dec 2023)
Liver transplantation in Latin America: reality and challenges
- David Aguirre-Villarreal,
- Maximiliano Servin-Rojas,
- Aczel Sánchez-Cedillo,
- Mariana Chávez-Villa,
- Roberto Hernandez-Alejandro,
- Juan Pablo Arab,
- Isaac Ruiz,
- Karla P. Avendaño-Castro,
- Maria A. Matamoros,
- Enrique Adames-Almengor,
- Javier Diaz-Ferrer,
- Erika Faride Rodriguez-Aguilar,
- Victor Manuel Paez-Zayas,
- Alan G. Contreras,
- Mario R. Alvares-da-Silva,
- Manuel Mendizabal,
- Claudia P. Oliveira,
- Miquel Navasa,
- Ignacio García-Juárez
Affiliations
- David Aguirre-Villarreal
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico
- Maximiliano Servin-Rojas
- Liver Transplant Unit and Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Department of Surgery, Massachusetts General Hospital, Boston, MA, USA
- Aczel Sánchez-Cedillo
- Department of Surgery, Hospital General de Mexico Dr. Eduardo Liceaga, Ciudad de Mexico, Mexico
- Mariana Chávez-Villa
- Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
- Roberto Hernandez-Alejandro
- Division of Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA
- Juan Pablo Arab
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada; Departament of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Isaac Ruiz
- Department of Hepatology and Liver Transplantation, Centre Hospitalier de l’Université de Montréal (CHUM), Canada
- Karla P. Avendaño-Castro
- Department of Gastroenterology, Hospital Monte Sinai, Cuenca, Ecuador
- Maria A. Matamoros
- Centro de Trasplante Hepatico y Cirugía Hepatobiliar, San Jose, Costa Rica
- Enrique Adames-Almengor
- Department of Internal Medicine and Gastroenterology, Hospital Santo Tomas, Panama
- Javier Diaz-Ferrer
- Department of Hepatology, Hospital Nacional Edgardo Rebagliati, Lima, Perú
- Erika Faride Rodriguez-Aguilar
- Department of Surgery, Hospital General de Mexico Dr. Eduardo Liceaga, Ciudad de Mexico, Mexico
- Victor Manuel Paez-Zayas
- Department of Surgery, Hospital General de Mexico Dr. Eduardo Liceaga, Ciudad de Mexico, Mexico
- Alan G. Contreras
- Transplant Surgery, Intermountain Transplant Clinic, Salt Lake City, UT, USA
- Mario R. Alvares-da-Silva
- GI/Liver Unit, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Manuel Mendizabal
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
- Claudia P. Oliveira
- Department of Gastroenterology (LIM07), Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Miquel Navasa
- Liver Transplant Unit, Hepatology Service, Hospital Clínic de Barcelona, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
- Ignacio García-Juárez
- Liver Transplant Unit and Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Corresponding author. Av. Vasco de Quiroga #15, Col. Belisario Dominguez Sector XVI, PC 14080, Tlalpan, Mexico City, Mexico.
- Journal volume & issue
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Vol. 28
p. 100633
Abstract
Summary: Healthcare systems in Latin America are broadly heterogeneous, but all of them are burdened by a dramatic rise in liver disease. Some challenges that these countries face include an increase in patients requiring a transplant, insufficient rates of organ donation, delayed referral, and inequitable or suboptimal access to liver transplant programs and post-transplant care. This could be improved by expanding the donor pool through the implementation of education programs for citizens and referring physicians, as well as the inclusion of extended criteria donors, living donors and split liver transplantation. Addressing these shortcomings will require national shifts aimed at improving infrastructure, increasing awareness of organ donation, training medical personnel, and providing equitable access to care for all patients.