Bharadwaj Hareesha Rishab, Tan Joecelyn Kirani, Ali Syed Hasham, Shah Muhammad Hamza, Nicholas Aderinto, Ahmed Khabab Abbasher Hussien Mohamed, Irfan Khansa, Dalal Priyal, Mehta Aashna, Awuah Wireko Andrew, Dhali Arkadeep
Faculty of Biology Medicine and Health, University of Manchester, Manchester M13 9PL, United Kingdom.
Faculty of Medicine, University of St Andrews, St Andrews KY16 9AJ, United Kingdom.
World J Gastrointest Pathophysiol. 2024 Nov 22;15(6):94590. doi: 10.4291/wjgp.v15.i6.94590.
This comprehensive review addresses the global health challenge of disparities in pancreas transplant access, particularly in low- and middle-income countries (LMICs) compared to high-income countries. Despite advancements in surgical techniques and immunosuppression for procedures like simultaneous pancreas-kidney, pancreas-after-kidney, and pancreas-transplant alone, LMICs face significant challenges, including limited infrastructure, financial constraints, and a shortage of skilled medical professionals. Donation after brain death remains constrained by sociocultural barriers. Region-specific analyses highlight progress in Latin America, Asia, Russia, and South Africa, showcasing the regional disparities in access and outcomes. Future prospects involve minimally invasive surgeries, telemedicine for enhanced post-operative care, international collaborations with organizations like the European Union of Medical Specialists, and robust funding networks to improve organ availability. In conclusion, the review underscores the importance of multifaceted strategies to address economic, sociocultural, and infrastructural barriers, aiming to improve accessibility, quality, and effectiveness of pancreas transplantation services in LMICs.
本综述全面探讨了胰腺移植可及性方面存在的全球健康挑战,尤其是与高收入国家相比,低收入和中等收入国家(LMICs)面临的挑战。尽管在同时进行胰腺-肾脏移植、肾脏移植后胰腺移植以及单独胰腺移植等手术技术和免疫抑制方面取得了进展,但LMICs仍面临重大挑战,包括基础设施有限、资金限制以及缺乏熟练的医疗专业人员。脑死亡后的捐赠仍受到社会文化障碍的限制。针对特定区域的分析突出了拉丁美洲、亚洲、俄罗斯和南非的进展,展示了在可及性和治疗结果方面的区域差异。未来的前景包括微创手术、用于加强术后护理的远程医疗、与欧洲医学专家联盟等组织的国际合作以及强大的资金网络,以提高器官的可获得性。总之,该综述强调了多方面策略对于解决经济、社会文化和基础设施障碍的重要性,旨在提高LMICs胰腺移植服务的可及性、质量和有效性。