Liver transplantation in the developing world

Abstract

Purpose of review: The purpose of the present paper is to review the problems of paediatric liver transplantation encountered by the developing world and to review the progress made.

Recent findings: Setting up of a transplant programme in the developing world is associated with multiple issues, including manpower training and lack of resources. Ethical issues, donor problems and lack of awareness about the benefit of liver transplantations among the medical profession and public are major problems. In countries where the programmes have been successfully established, the outcome and long-term survival rates are comparable to those of the developed world. The complication rates are similar to those in developed countries. De-novo hepatitis B is a risk factor among the recipients and maintaining a high anti-hepatitis B among the recipients prior to transplantation appears to be the solution.

Summary: Various problems encountered in the developing countries are reviewed. The long-term actuarial survival rates in those countries are encouraging.