INTRODUCTION

Liver transplantation is the definitive treatment for end-stage liver disease. Deceased and living donors are the two primary organ sources. Living donor liver transplantation (LDLT) reduces waiting times and has a better overall survival rate, but requires an advanced infrastructure, trained medical personnel, and social awareness. These, often limit its establishment in low- and middle-income settings. In Mexico, where liver transplantation programs are unequally distributed across the country, deceased donor liver transplants (DDLT) predominate. Despite LDLT’s benefits, its implementation is limited, resulting in significant disparities.

METHODS

We performed a retrospective observational study collecting data from Mexico’s National Transplant Registry (CENATRA). We analyzed the total hepatic transplants performed from 2000 to 2023. Differences between DDLT and LDLT were evaluated using the Mann-Whitney U test, with statistical significance defined as p<0.05.

RESULTS

In Mexico, between 2000 and 2023  a total of 3,176 liver transplants were performed. 2,954 DDLT (93%) and 222 LDLT (7%). A statistically significant difference between DDLT and LDLT was observed (p<0.0001). The median annual LDLT was 8.5 (95% CI: 6–11), in contrast with DDLT which was 98.5 (95% CI: 80.5–162).

CONCLUSION

The disparity of access to LDLT compared with DDLT in Mexico highlights systemic and social challenges. Limited training hospitals, a diminished number of transplant surgeons, and low public awareness are some of the main reasons that complicate LDLT adoption as a main alternative treatment for end-stage liver disease patients. Addressing these issues is crucial to achieving equitable access to liver transplantation in Mexico, and improving patient outcomes.