Gondolesi Gabriel E, Doeyo Mariana, Solar-Muñiz Héctor
Unidad de Insuficiencia, Rehabilitación y Trasplante Intestinal - Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina.
Curr Opin Organ Transplant. 2020 Apr;25(2):189-195. doi: 10.1097/MOT.0000000000000737.
Latin America and the Caribbean represent a vast territory, with very different economic and healthcare realities, which result in significant disparities in the management of intestinal failure patients throughout the region. Since 1968, multiple attempts have been done to accomplish a successful intestinal transplant; but it was not until 2004, with the establishment of multidisciplinary programs, that large series with long-term results could be obtained. Currently, three countries (Colombia, Argentina, and Brazil) in the region are actively performing these procedures.
A total number of 135 intestinal transplants have been performed; 11 attempts before 2004, and 124 after that period, 66 transplants were done in Argentina (42 in children), 40 in Colombia, 15 in Brazil (1 child), 2 in Costa Rica and 1 in México; 76% have been isolated, whereas 2 were done with living donors.
Publications are still scarce, and compliance to existing registries remains limited. The challenge for the next years is to develop more 'comprehensive units' and extend home parenteral nutrition availability in the rest of the region. Regional cooperation and networking need to be set, in order to achieve regional self-sufficiency and improve long-term results.
拉丁美洲和加勒比地区地域广阔,经济和医疗现状差异极大,这导致该地区在肠衰竭患者管理方面存在显著差异。自1968年以来,人们多次尝试成功进行肠道移植;但直到2004年,随着多学科项目的建立,才获得了具有长期结果的大量病例系列。目前,该地区有三个国家(哥伦比亚、阿根廷和巴西)积极开展这些手术。
总共进行了135例肠道移植;2004年之前有11次尝试,之后有124例,阿根廷进行了66例移植(儿童42例),哥伦比亚40例,巴西15例(1名儿童),哥斯达黎加2例,墨西哥1例;76%为孤立性移植,2例为活体供体移植。
相关出版物仍然稀少,对现有登记处的依从性仍然有限。未来几年的挑战是在该地区其他地方建立更多“综合单位”并扩大家庭肠外营养的可及性。需要建立区域合作和网络,以实现区域自给自足并改善长期结果。