INTRODUCTION

In Mexico, the landscape of pediatric liver transplantation (PLT) is characterized by fierce challenges. Access to specialized liver transplants (LT) remains limited and families often seek help outside our country. Transplant professionals continue to have limited protected time and economic incentives to provide multidisciplinary complex care. A limited number of surgeries are performed nationwide. In 2017 the establishment of a mentorship/partnership training program emerged as a novel initiative, focused on empowering Mexican transplant professionals to navigate the complexities of PLT within the context of global surgery.

METHODS

This is a retrospective observational study. We collected data from May 2017 to February 2025, including demographics, diagnosis, surgeries performed, and location. Surgeries were done in Mexico and the US. Our multidisciplinary team included surgeons, hepatologists, anesthesia, critical care, pediatrics, and coordinators, collaborating with Mexican transplant healthcare professionals. Educational, preoperative, surgical, and postoperative care protocols were developed by our team.

RESULTS

Over the last 8 years, we performed a total of 15 surgeries on 11 Mexican pediatric patients with 6 boys and 5 girls. The mean age was 3 years (15mo-8yo). Eight LTs were done, 3 of them in the US and 5 in Mexico, 75% of them had biliary atresia, and 25% had hepatoblastoma. Additionally, 1 distal splenorenal shunt, 1 REX-bypass, 2 hepatic resections, and 1 internal biliary derivation were also performed. Of the LT patients, one went back to the OR for a PV revision on POD#5, and one required a biliary reconstruction 3 years later. 11 surgeries were performed in 3 Mexican hospitals and 4 in 2 US hospitals. Eight Mexican surgeons were part of the local program. All the surgeries received financial support from 6 different NPOs based in the US and Mexico. One patient died within 30 days and 1 HBL patient passed away 3 years after transplant. All patients are followed in Mexico in collaboration with Institutions in the US.

CONCLUSION

The mentorship program established in Mexico for PLT has demonstrated significant progress since its creation. Through collaboration between healthcare professionals in Mexico and the US, the program has successfully enhanced transplant mentorship, introduced innovative techniques, and developed a model that could increase access to PLT for patients. The main limitation remains to be economic access in our objective of increasing the reach of the program. As part of this interaction, we have obtained 2 grants supported by International Societies that enhance the scope of the program, not only with the US but also with centers in Asia with expertise in LDLT. We currently have 3 more LTs scheduled in Mexico. Continuing the efforts in collaboration is essential to keep advancing in  PLT and LDLT in Mexico and beyond, ultimately improving outcomes for pediatric patients worldwide.