Liver transplantation in Latin America: reality and challenges

Abstract

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.

Keywords: Cirrhosis; Extended criteria donor; Latin America; Live donor; Liver transplant; MELD allocation; Normothermic machine perfusion; Split liver transplant.

Fig. 1

(a) Averaged deceased donors in the last five years (2018–2022) in Latin America per million population (pmp). (b) Averaged deceased donor LT (DDLT) in the last five years (2018–2022) in Latin America per million population (pmp). (c) Averaged live donor LT (LDLT) in the last five years (2018–2022) in Latin America per million population (pmp).

Fig. 2

Decrease in LT during the COVID-19 pandemic (%) from 2019 to 2020.