Consolidating Transplant Efforts Throughout Mexico

Thousands of people are waiting for a transplant that could be the difference between life and death. To improve their chances, the National Transplant Center (CENATRA) is bringing together the public and private sectors and promoting agreements to make these surgeries a reality. “CENATRA coordinates the efforts off all players, including the federal government, state governments, local health centers, the Ministry of Health and society itself,” says José Aburto, Director General of CENATRA. “When we began managing CENATRA, only five states participated. Now, 18 states are involved and we continue to incorporate more as they develop their own initiatives and attract organ donors. If all public institutions work together under unified standards, we can raise the rate of transplants in Mexico.”

Mexico’s transplant rate is 4.5 per million inhabitants, says Aburto, so challenges are related to the many factors that must be aligned for a transplant to be viable. These include hospital space and the availability of the medical professionals required to perform the transplant. A common problem is that the organ, the patient and the doctors are in different states, demanding appropriate logistics and coordination. “Each successful case requires the coordination of several institutions and doctors so as not to miss a transplant opportunity,” explains Aburto

To address geographical dilemmas, CENATRA has at its disposal an aircraft belonging to the Attorney General’s Office (PGR). “This agreement was created by our administration as there was no way to transport an organ, the doctor or the patient. Air transport is extremely expensive, with prices between MX$200,000 and MX$300,000. Collaboration with PGR has been essential for many transplants in recent years.”

The most common transplant in Mexico is for a kidney, with 13,702 people on the waiting list, most of them between 35 and 45 years of age. Kidney transplants have a survival rate of 90 percent during the first year, 85 percent after five years and 80 percent after 10 years. Patients can survive up to 20 years after a kidney transplant and, on average, survive for 15 years, says Aburto. Meanwhile hemodialysis, an extremely expensive substitute treatment, results in a survival rate of between two and four years. “The entire healthcare budget would not be enough to pay for hemodialysis for all the patients who need it now,” adds Aburto.

Cornea transplants are second, with 7,267 patients on the waiting list. “There are 3,762 annual transplants, of which 2,874 are from Mexican donors. Two years ago, 80 percent of corneas came from the US.” Liver is next, with 365 patients waiting for a liver transplant as of February 2018. “In 2017, 183 transplants were performed, so we are covering 50 percent of the demand. Over 90 percent of these transplants are successful.”

Although there are only 47 patients on the waiting list for heart transplants, their quality of life is greatly decreased due to their condition, says Aburto. “In 2017, we successfully performed 35 heart transplants, covering 70 percent of the existing need.” Successful heart transplants in the country are performed mostly at public institutions.

Among CENATRA’s many goals was the creation in 2017 of a program for lung transplants that concluded with four surgeries carried out in Monterrey. “It is a very complex operation that requires extensive infrastructure and well-trained professionals, including surgeons and ICU professionals.”

The institution supports other projects that can place Mexico as a world leader in transplants, including facial and thoracic extremities. “Mexico is the first country in Latin America to transplant upper body extremities,” says Aburto. Other countries such as Spain, the world leader in transplants, have developed successful programs through the generation of special budgets assigned exclusively for that goal. “The resources we have received have led to all these results. All successful models go hand in hand with an appropriate budget. All activity related to transplants in Mexico is completely altruistic thanks to the donation of time and resources from doctors, nurses and hospitals. These people do not receive any compensation for their significant efforts.”