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Annals of Hepatology
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Inicio Annals of Hepatology O-7 CURRENT PRACTICE OF LIVER TRANSPLANTATION IN LATIN AMERICAN COUNTRIES: AN AL...
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Vol. 29. Núm. S1.
Abstracts of the 2023 Annual Meeting of the ALEH
(febrero 2024)
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Vol. 29. Núm. S1.
Abstracts of the 2023 Annual Meeting of the ALEH
(febrero 2024)
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O-7 CURRENT PRACTICE OF LIVER TRANSPLANTATION IN LATIN AMERICAN COUNTRIES: AN ALEH INTEREST GROUP SURVEY 2023
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Paulo Bittencourt1, Liana Codes1, Adrian Gadano2, Alejandra Villamil2, Alfeu de Medeiros Fleck Jr3, Álvaro Urzua4, Debora Raquel Terrabuio5, Eira Cerda6, Graciela Elia Castro Narro7, Ignacio Roca8, John Abad González9, Josefina Pages10, Juan Carlos Restrepo Gutierrez11, Leonardo de Lucca Schiavon12, Mario Uribe13, Martin Padilla14, Norma Marlene Perez Figueroa15, Pablo Coste Murillo16, Raquel Stucchi17, Ricardo Chong18..., Rodrigo Wolff19, Victoria Mainardi20, Rodrigo Zapata21Ver más
1 Portuguese Hospital, Salvador, Bahia, Brasil
2 Italian Hospital, Buenos Aires, Argentina
3 Adult Liver Transplant Group, Santa Casa Misericórdia, Porto Alegre, Rio Grande do Sul, Brasil
4 Clinical Hospital, University of Chile, Santiago, Chile
5 Clinical Hospital, University of São Paulo, São Paulo, Brasil
6 Central Military Hospital, Mexico City, México
7 National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, México
8 El Cruce Hospital, Buenos Aires, Argentina
9 Carlos Andrade Marín Hospital, Quito, Ecuador
10 Austral University Hospital, Buenos Aires, Argentina
11 Pablo Tobon Uribe Hospital, Medellin, Colombia
12 Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brasil
13 Del Salvador Hospital, Santiago, Chile
14 Guillermo Almenara National Hospital, Lima, Perú
15 General Plaza de la Salud Hospital, S. Domingos, República Dominicana
16 RA Calderón Guardia Hospital, San Jose, Costa Rica
17 State University of Campinas, Campinas, Brasil
18 Francisco Clinic, Quito, Ecuador
19 Red de Salud UC Christus, Santiago, Chile
20 National Liver Transplant Program, Montevideo, Uruguay
21 Alemana Clinic, Santiago, Chile
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Vol. 29. Núm S1

Abstracts of the 2023 Annual Meeting of the ALEH

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Introduction and Objectives

Little is known about current practice of liver transplantation (LT) in Latin American countries (LATAM). This study aimed to describe LT activity, immunosuppression protocols and policies regarding prophylaxis of cytomegalovirus (CMV) infection and hepatitis B virus (HBV) recurrence in different active LATAM centers.

Materials and Methods

A web-based survey with 20 questions regarding LT practice was sent to all members of ALEH LT SIG in December 2022.

Results

22 centers performing 35 [5-160] LT per year from Brazil (n=5), Argentina (n=4), Chile (n=4), Ecuador (n-2), Mexico (n=2), Colombia (n=1), Costa Rica (n=1), Peru (n=1), Dominican Republic (n=1) and Uruguay (n=1) answered the survey. Tacrolimus, mycophenolate and prednisone was the main immunosuppressive regimen employed by most (72%) centers and 81% of them referred basiliximab use for induction therapy in selected patients. Tailoring of immunosuppression was universally accepted, particularly in autoimmune hepatitis (AIH) (59%), hepatocellular carcinoma (54%) kidney dysfunction (77%) and primary biliary cirrhosis (33%). Weaning of corticosteroids at three, six and 12 months after LT was reported, respectively, by 41%, 36% and 23% of the centers, but policy for lifelong corticosteroid use in AIH-transplanted subjects was commonly observed (90%). Just four centers are currently performing protocol liver biopsies, while 18 of them are considering liver biopsy prior to steroid pulse therapy. HBIG and nucleos(t)ide analogs are used in most instances (73%) for HBV recurrence prevention, whereas CMV infection prophylaxis was shown to vary sharply across centers. Of note, all but two of them referred major changes in LT practice over the years due to economical restraints.

Conclusions

Compliance with standard of care recommendations for management of LT was reported by most centers. Heterogeneity in practices regarding HBV infection recurrence and CMV prophylaxis may reflect local financial restraints and point to the importance of developing ALEH guidelines to encourage LT activity in LATAM.

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