Mexico's Organ Shortage Crisis: Waiting List Double the Number of Organs Available

In this article, we discuss proposals to increase organ donation in Mexico. With the waiting list for organs more than double the number of functional units available, it is crucial to carry out continuous organ and tissue donation campaigns to increase the number of donors in Mexico.

Mexico's Organ Shortage Crisis: Waiting List Double the Number of Organs Available
Dante Amato Martinez, professor at the Surgeon Medical School of the Faculty of Superior Studies Iztacala of the UNAM, proposes solutions to increase the number of organ donations in Mexico. Credit: UNAM

The number of people waiting for an organ transplant in Mexico is more than double the number of organs available, according to data from the Ministry of Health. At the end of 2021, 22,859 individuals were on the waiting list for organs or tissues. Kidney transplants topped the list, with 17,299 people waiting for this life-saving procedure, followed by 5,259 for cornea transplants, 238 for liver transplants, and 54 for heart transplants. In addition, nine people needed two organs.

Chronic kidney disease has a global prevalence of 9.1 percent, causing an estimated 1.2 million deaths annually and a loss of 35.8 million years of life. The Global Observatory on Donation and Transplantation reports that every year more than 100,000 kidney procedures are performed worldwide, compared to the over five million patients who undergo dialysis annually.

Dante Amato Martinez, professor at the Surgeon Medical School of the Faculty of Superior Studies Iztacala of the UNAM, stresses that organ transplants are often the only option to save lives in the face of diseases like heart failure, cirrhosis, severe acute liver failure, liver cancer, and renal failure, among others. However, kidney surgery is the most common type of transplant in Mexico and the world.

According to data from the GODT, nearly all of the 2,143 transplants performed in Mexico in 2021 were kidney surgeries (1,974, or 92 percent), with only 135 liver surgeries (six percent), 26 heart surgeries, and six lung surgeries. No small intestine or pancreas surgeries were reported.

The United States and Spain lead the world in transplantation, performing 25,490 and 2,950 kidney transplants, respectively, in 2021. In comparison, Mexico performed 1,974 kidney transplants, while Argentina, with a smaller population, performed 1,237.

Of the two sources of kidney donation, living donors are the most common in Mexico, followed by cadavers. The opposite is true in Spain, where legislation allows for the use of organs by most of the human beings who die in the country. In Mexico, only one in four transplants come from a deceased person, whereas in Spain, there are approximately eight cadaveric donations for every donation from a living person.

The COVID-19 pandemic led to a decrease in organ transplants worldwide, but the activity has since recovered and is growing by 13 percent, according to Martinez. Nevertheless, Mexico has a long way to go to catch up to other countries in terms of the number of organ transplants per million inhabitants, with only 15.15 pmh compared to 76.57 pmh in the US, 63.37 pmh in Spain, 27.13 pmh in Argentina, and 21.3 pmh in Brazil.

Proposals to Increase Organ Donation in Mexico

According to Dante Amato Martínez, a professor at the Surgeon Medical School of the Faculty of Superior Studies Iztacala of the UNAM, Mexico has almost 100 centers and skilled transplantologists, but the number of organ procedures is low. The waiting list for organs is at least twice the number of functional units available, and most donors come from living donors. Martínez proposes several solutions to increase the number of organ donations in Mexico.

Firstly, he suggests that Mexico should adopt similar legislation to Spain, where it is assumed that if an individual did not express their desire not to donate their organs when they die, it is considered that they accept organ donation. In Mexico, permission must be sought from the bereaved, most of whom will refuse. Martínez believes that the change in legislation could increase the donation culture.

Secondly, he stresses the importance of supporting people who receive kidney transplants. In addition to complex and expensive surgical procedures, transplant patients must take immunosuppressants, which are also expensive. Continuous support is crucial to ensure the well-being of transplant patients.

Furthermore, Martínez highlights the cost-effectiveness of organ transplants compared to dialysis. While dialysis is less expensive, the cost/benefit ratio of transplantation is much more favorable. He emphasizes that a transplanted patient's quality of life is much better than that of a dialysis patient.

Martínez also emphasizes the impact that a single donor can have on multiple lives. A cadaveric donor can save the lives of five to seven people through the donation of their heart, lungs, liver, pancreas, kidneys, small intestine, and other tissues. Living donors can also donate a kidney or a segment of the liver after a series of medical examinations.

Finally, Martínez stresses the importance of continuous educational and convincing work by the government and non-governmental organizations to increase the number of donors. He believes that increasing organ donation is an act of solidarity and could allow children and adults to recover their health and preserve their lives.