Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico.
Department of Surgery, Hospital Aleman, Buenos Aires, Argentina.
Int J Surg. 2020 Oct;82S:14-21. doi: 10.1016/j.ijsu.2020.03.039. Epub 2020 Apr 1.
The lack of adequate financial coverage, education, and the organization has been the main limiting factor for the development of transplantation in Latin America. As occurred worldwide, the number of patients on liver waiting lists in Latin America grows disproportionately compared to the number of liver transplantations (LTs) performed. Although many law modifications have been made in the last year, most countries lack social awareness about the importance of donation and the irreversibility of brain death. The mechanisms and norms for organ procurement and infrastructure development, capable of supporting this high demand, are still in slow progress in most countries. Access to LT in the region is very heterogeneous. While some countries have no active LT programs so far, others are an international model of a public transplantation system (Brazil) or a national information system (Argentina). While some countries have only a few LT centers, others have too many LT centers performing an inadequate low number of LTs. Disparity to access transplantation remains the major challenge in the region. Cultural and educational efforts have to be accompanied by transparent public policies that will likely increase organ donation and activity in transplantation. The purpose of this article is to review the trends and current activity in LT within Latin America, based on prior publications and the information available in each country of the region.
缺乏足够的财政覆盖、教育和组织一直是拉丁美洲移植发展的主要限制因素。与肝移植 (LT) 的数量相比,拉丁美洲的肝等待名单上的患者数量不成比例地增加,这种情况在全球范围内都有发生。尽管去年进行了许多法律修改,但大多数国家对捐赠的重要性和脑死亡的不可逆转性缺乏社会意识。在大多数国家,器官获取和基础设施发展的机制和规范仍在缓慢推进,这些机制和规范能够满足这种高需求。该地区获得 LT 的机会非常不均衡。虽然一些国家迄今为止没有积极的 LT 计划,但其他国家则是公共移植系统的国际典范(巴西)或国家信息系统(阿根廷)。虽然一些国家只有少数几个 LT 中心,但其他国家的 LT 中心太多,而 LT 的数量却不足。获得移植的机会存在差异仍然是该地区面临的主要挑战。文化和教育工作必须辅以透明的公共政策,这可能会增加器官捐赠和移植活动。本文的目的是根据拉丁美洲各国的既往出版物和现有资料,回顾 LT 在拉丁美洲的趋势和当前活动。