Creation of a Solid Organ Transplant Program in an Underdeveloped Country: Mexicoʼs General Hospital Transplantation Program

• DOI: 10.1097/00007890-201211271-01604
• Publication Date: 2012-11-07T07:56:26Z
• Authors: L. Garcia; A. Cicero; H. Hinojosa; A. Rossano; D. Fernandez; A. Luque; J. Cordova; H. Diliz
• Keywords: Immunosuppression

Mexico has a population of over 112 million. All Mexicans are entitled to receive medical care by the state, more than half limited access healthcare. Our hospital was founded in 1905. It currently 1126 beds, caring for millions with low income and without social security. Hospital reflects health problems: cancer, diabetes, hypertension, chronic kidney disease cirrhosis. From January 1985 March 2009, 40 renal transplants were performed from living donors high percentage complications. This is why April 2009 new Solid Organ Transplantation Program started. Objective: To present our program international transplant community briefly give perspective Mexican situation. Material methods: Restrospective chart review: November 2011. Kidney liver recipients included. We described demographics, initial function at month 1, immunosuppression Results: 68 (59 9 deceased donors) 5 (cadaveric donors). transplant: 73.5% male, mean age 29.77 (range 18-60). Donor 34.08 years. Cause disease: unknown 63%, hypertension 19%, hipoplasia 7%, other causes (diabetes infectious glomerulonephritis) 11%. Mean creatinine pre-transplant 13.32mg/dL, day 5, 2.33mg/dL 1.32mg/dL. Average MDRD pre-transplant, 1 post-transplant 6.39, 53.15 69.80mg/dL, respectively. grafts lost (7.3%): 4 deaths functioning due acute pyelonephritis. Complication: 2 urinary leaks, ureteral stenosis, two cases cellular rejection 6 patients presented delayed graft function. but one received basiliximab induction (one Thymoglobulin PRA), maintenance therapy includes calcineurin inhibitor, MMF prednisone. Liver transplants: 83.6% women. Etiology: alcoholic cirrhosis, hepatitisC (1 hepatocelluar carcinoma) primary billiary Complications: pneumonia 4, reperfusion syndrome convulsive crisis (medication), ARDS death 1. MELD: 10 21. Induction tacrolimus, steroids. 26.2 have normal tests currently. Conclusions: performed, complications included donor deaths. The started 2009. Results comparable centers, complication rate less 15%. still long road travel, number seen In organ failure growing. working authorities obtain pancreas transplantation license hope be pioneers this field soon. meant an example all programs country we lot do.