Letter to editor
Liver transplants in Mexico, sociodemographic characteristics of donors and receptors between 2007 & 2019.
a Escuela de Medicina, Ciencias de la Salud, Universidad Marista de Mérida, México
b Cirugía de Hígado, Páncreas y Vías Biliares, Profesor titular del curso de Cirugía general, Hospital Regional de Alta Especialidad de la Península de Yucatán Mérida, México
c Subdirección de Enseñanza e Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán Mérida, Calle 7 # 433 × 20 y 22, Altabrisa, C.P. 97130 Mérida, Yucatán, México
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"documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Ann Hepatol. 2021;24C:" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letters to the editor</span>" "titulo" => "Characteristics and in-hospital outcomes of COVID-19 patients with abnormal liver biochemical tests" "tienePdf" => "en" "tieneTextoCompleto" => "en" "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2218 "Ancho" => 2175 "Tamanyo" => 260735 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: The incidence of adverse outcomes in patients with abnormal versus normal liver biochemical tests at admission. B: The incidence of adverse outcomes in patients with abnormal versus normal liver biochemical tests during hospitalization.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Yanyan Wu, Zhuang Ma, Xiaozhong Guo, Hongyu Li, Yufu Tang, Hao Meng, Hao Yu, Chengfei Peng, Guiyang Chu, Xinwei Wang, Yue Teng, Quanyu Zhang, Tianyi Zhu, Bing Wang, Zhenhua Tong, Ruirui Feng, Haitao Zhao, Hui Lu, Xingshun Qi" "autores" => array:19 [ 0 => array:2 [ "nombre" => "Yanyan" "apellidos" => "Wu" ] 1 => array:2 [ "nombre" => "Zhuang" "apellidos" => "Ma" ] 2 => array:2 [ "nombre" => "Xiaozhong" "apellidos" => "Guo" ] 3 => array:2 [ "nombre" => "Hongyu" "apellidos" => "Li" ] 4 => array:2 [ "nombre" => "Yufu" "apellidos" => "Tang" ] 5 => array:2 [ "nombre" => "Hao" "apellidos" => "Meng" ] 6 => array:2 [ "nombre" => "Hao" "apellidos" => "Yu" ] 7 => array:2 [ "nombre" => "Chengfei" "apellidos" => "Peng" ] 8 => array:2 [ "nombre" => "Guiyang" "apellidos" => "Chu" ] 9 => array:2 [ "nombre" => "Xinwei" "apellidos" => "Wang" ] 10 => array:2 [ "nombre" => "Yue" "apellidos" => "Teng" ] 11 => array:2 [ "nombre" => "Quanyu" "apellidos" => "Zhang" ] 12 => array:2 [ "nombre" => "Tianyi" "apellidos" => "Zhu" ] 13 => array:2 [ "nombre" => "Bing" "apellidos" => "Wang" ] 14 => array:2 [ "nombre" => "Zhenhua" "apellidos" => "Tong" ] 15 => array:2 [ "nombre" => "Ruirui" "apellidos" => "Feng" ] 16 => array:2 [ "nombre" => "Haitao" "apellidos" => "Zhao" ] 17 => array:2 [ "nombre" => "Hui" "apellidos" => "Lu" ] 18 => array:2 [ "nombre" => "Xingshun" "apellidos" => "Qi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S166526812100048X?idApp=UINPBA00004N" "url" => "/16652681/000000240000000C/v7_202205201403/S166526812100048X/v7_202205201403/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to editor</span>" "titulo" => "Liver transplants in Mexico, sociodemographic characteristics of donors and receptors between 2007 & 2019." "tieneTextoCompleto" => true "saludo" => "Dear editor:" "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Rodrigo Gaspar Díaz Novelo, Rubén R. Lozano Salazar, Nina Méndez Domínguez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Rodrigo Gaspar Díaz" "apellidos" => "Novelo" "email" => array:1 [ 0 => "rodgasdn@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0001" ] ] ] 1 => array:4 [ "nombre" => "Rubén R." "apellidos" => "Lozano Salazar" "email" => array:1 [ 0 => "pancreas.rr@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0002" ] ] ] 2 => array:4 [ "nombre" => "Nina Méndez" "apellidos" => "Domínguez" "email" => array:1 [ 0 => "nina.mendez@salud.gob.mx" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0003" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0001" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Escuela de Medicina, Ciencias de la Salud, Universidad Marista de Mérida, México" "etiqueta" => "a" "identificador" => "aff0001" ] 1 => array:3 [ "entidad" => "Cirugía de Hígado, Páncreas y Vías Biliares, Profesor titular del curso de Cirugía general, Hospital Regional de Alta Especialidad de la Península de Yucatán Mérida, México" "etiqueta" => "b" "identificador" => "aff0002" ] 2 => array:3 [ "entidad" => "Subdirección de Enseñanza e Investigación, Hospital Regional de Alta Especialidad de la Península de Yucatán Mérida, Calle 7 # 433 × 20 y 22, Altabrisa, C.P. 97130 Mérida, Yucatán, México" "etiqueta" => "c" "identificador" => "aff0003" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0001" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0002" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1787 "Ancho" => 3583 "Tamanyo" => 174120 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0002" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Geographic distribution of the place of residence of 1841 patients who received liver tranplant in Mexico between 2007 and 2019.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="para0003" class="elsevierStylePara elsevierViewall">After reading the article entitled <span class="elsevierStyleItalic">Waitlist mortality and transplant-free survival in Hispanic patients listed for liver transplant using the UNOS database</span> by Goyes, Danford, Nsubugab & Bonder <a class="elsevierStyleCrossRef" href="#bib0001">[1]</a>, we gained comprehension of how, even after implementing policies to ensure the highest priority for patients at higher risk for mortality, inequities still exist, and the Hispanic population is affected. Thus, we hypothesized that disparities may be extensive for Hispanic-speaking countries such as Mexico and aimed to describe the epidemiological profile of liver transplants in Mexico between 2007 and 2019.</p><p id="para0004" class="elsevierStylePara elsevierViewall">We developed a retrospective study based on open access data from the National Transplant Registry (Cenatra) <a class="elsevierStyleCrossRef" href="#bib0002">[2]</a>; Stata14 software was used for descriptive statistics and group comparison tests. Variables including age, gender, state of residence, and living/cadaveric donor were included.</p><p id="para0005" class="elsevierStylePara elsevierViewall">Mexico had a liver transplant rate of 1.53 per 100,000 inhabitants in the 12-year period (1.27 per million inhabitants yearly). As of June 30<span class="elsevierStyleSup">th</span>, 2020, 314 patients were on the waiting list; of this group, 44 (14%) resided in Mexico City, and 86% resided in any of the 31 Mexican states. Between January 2007 and December 2019, 1841 donors (age 28.85 ± 0.33) provided liver transplants for 1841 recipients (age 42.85 ± 0.66), of whom 943 (54%) were women. Eleven percent of transplants were from live-related donors or for pediatric recipients (age 11.5 ± 1.12); missing data from donor registries were identified in 27 cases. <a class="elsevierStyleCrossRef" href="#fig0001">Fig. 1</a> presents mean age by state.</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia><p id="para0006" class="elsevierStylePara elsevierViewall">In 908 cases, the liver was not the only donated organ; 480 liver donors also provided 870 kidneys, 4 lungs, 2 pancreases, 726 corneas, 39 skin grafts, 122 bone tissue, and 22 hearts. The average time spent on the wait list for patients who received transplants from related live liver donors was 160 days, and there were 225 cadaveric donors. Twenty-eight percent of transplants (<span class="elsevierStyleItalic">N</span> = 515) were performed in private hospitals, and 72% at public institutions. The public institution where the most transplants took place was the Mexican Institute of Social Security (IMSS), with 490 transplants (26.6%). Of all transplants, 966 took place in Mexico City and the surrounding area (Estado de México), while 444 donors and 403 recipients resided in the same city. The geographical distribution of the recipients´ place of residence is shown in <a class="elsevierStyleCrossRef" href="#fig0002">Fig. 2</a>. The waiting time for patients was 223 days, but in the capital city Ciudad de Mexico, the average was 193.5 days.</p><elsevierMultimedia ident="fig0002"></elsevierMultimedia><p id="para0007" class="elsevierStylePara elsevierViewall">In conclusion, we may add to Goyes et al. that disparities in access and availability of liver transplants occur in Mexico as well, where the population located outside of main cities is mostly affected. There are areas of improvement in Mexico regarding the approach to donation, allocation, and transplantation of hepatic tissue from living and cadaveric donors, but the lack of complete information such as patient disease severity and waiting list dynamics are needed to monitor the effect of future programs aimed at addressing these inequities. Efforts are needed to decentralize liver transplants and reduce inequities in access and availability in order to reinforce and maintain donation campaigns while facilitating a timely allocation both in the states and in the capital city.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="notep0001">Conflict of interest: None to declare.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0001" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1566 "Ancho" => 3583 "Tamanyo" => 276845 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0001" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Average age (in years) of donors and recipients of Liver Trasplants performed in mexico between 2007 and 2019 by state.</p>" ] ] 1 => array:8 [ "identificador" => "fig0002" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1787 "Ancho" => 3583 "Tamanyo" => 174120 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "alt0002" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spara002" class="elsevierStyleSimplePara elsevierViewall">Geographic distribution of the place of residence of 1841 patients who received liver tranplant in Mexico between 2007 and 2019.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec1" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0001" "etiqueta" => "[1]" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Waitlist mortality and transplant free survival in Hispanic patients listed for liver transplant using the UNOS database" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D Goyes" 1 => "CJ Danford" 2 => "JP Nsubuga" 3 => "A. Bonder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.aohep.2021.100304" "Revista" => array:3 [ "tituloSerie" => "Ann Hepatol" "fecha" => "2021" "volumen" => "23" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0002" "etiqueta" => "[2]" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "National Center for Transplants (Cenatra). Open Access datasets Datos Abiertos de México -CENATRA - Instituciones Last Update 04/10/2021." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/000000240000000C/v7_202205201403/S1665268121002210/v7_202205201403/en/main.assets" "Apartado" => array:4 [ "identificador" => "82754" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/16652681/000000240000000C/v7_202205201403/S1665268121002210/v7_202205201403/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268121002210?idApp=UINPBA00004N" ]
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