High demand for organ transplants linked to the prevalence of diabetes

Organ donation in our country registers extremely low rates in comparison with nations with similar socioeconomic conditions and with the average reported in Latin America, affirms Omar Sánchez Ramírez, an academic from the Faculty of Medicine (FM) of the UNAM.

For example, the cadaveric type in 2019 was 3.78 per million inhabitants, while the average for Latin America, was 9.5. The rate of kidney transplants-both live and cadaveric-is 22.4 per million inhabitants in Mexico, compared to Argentina, which is 37.1; and in Uruguay, 44.3. It is worth mentioning that in our nation there are 273 centers authorized to perform them, in Argentina 59, and Uruguay only three.

Spain and the United States have rates of 73.8 kidney implants per million inhabitants, according to data from the Global Observatory on Organ Donation and Transplantation. On the occasion of World Transplant Day -which is commemorated on February 27th- the Evaluation Coordinator of the Department of Surgery at FM explains:

The high demand for this organ, heart, and liver is intimately linked to the prevalence we have of diabetes and its relationship with arterial hypertension and renal failure, "which creates a worrisome scenario because it exceeds the possibilities of care with other resources". Interventions are, on numerous occasions, the only way out left for patients with chronic degenerative diseases, with whom the usual therapeutic resources have been exhausted.

There are solid organ transplants, such as kidney, liver, heart, intestine, and lung, which are different from tissue transplants, such as the cornea and skeletal muscle. There are others called combined, in which several types of tissue, bone, and muscle are involved, such as the replacement of arms and, recently, of the face.

The cost of the procedure and supplies to obtain a kidney from a deceased person was, until a few years ago, approximately 13,000 pesos, while from a living human being it was about 130,000 pesos. It is important to remember that the granting of an organ is an altruistic action.

Quality programs are urgently needed

Sánchez Ramírez and his colleagues Rubén Argüero Sánchez and Enrique Olivares Durán recently published articles in the Mexican Medical Gazette where they state that, for example, the most demanded organ in the Mexican nation is the kidney, representing 97 percent of the waiting list for solid organs. From 2012 to 2019 the number of patients who received a transplant was less than the number of people registered for the first time on the list.

It is common to attribute the low numbers to a lack of donation culture, but little is turned to look at the healthcare system and medical structure to obtain organs and tissues.  "It is there where the Spanish have insisted that the success of their activity lies."

In Spain, there is a single health system and the hospitals where organ donation can be obtained are identified, for example, those that treat trauma. Plus, there are multidisciplinary teams in charge of these processes, infrastructure, and personnel to carry out the required studies at the time the need arises.

"The family's response to the donation request is only one step, of a series of very important steps. The family is the supposed culture, but the rest is the responsibility of the structure, the organization, and the policies to attend a program. There is no quality follow-up in which processes are seen and evaluated to obtain organs, to see where the problem is stuck. There are no quality programs," he says.

Mexico has more hospitals authorized to perform the intervention than the United States or Spain. "They have the license, but very little is done, so much so that there are hospitals that do not report donations or transplants over the years".

There are outstanding institutions in this task, such as the National Medical Center La Raza, where the largest number of heart transplants are performed in our country, in addition to the High Specialty Medical Unit of the 34th Cardiology Hospital, in Monterrey. There is also important kidney transplant activity from living persons at the Hospital Civil de Guadalajara and the Centro Médico Nacional Siglo XXI, as well as in states such as Guanajuato and Puebla; however, demand is high.

How to become an organ donor in Mexico?

September 26th is the National Day of Organ and Tissue Donation and Transplantation, for this reason, we explain how to become an organ donor in life or death in Mexico. According to information from the federal government, in Mexico, the General Health Law establishes that donation consists of the tacit or express consent of the person so that during life or after death, his or her body or any of its components are used for transplants.

The National Transplant Center has the "official document of donation", with which you can express your consent to become a donor of organs, tissues, and cells after death so that they can be used for transplants.

To carry out this procedure you need a valid official ID and two witnesses, the official form to express consent to donate organs and go to the National Transplant Center (Cenatra), located at Carretera Picacho Ajusco 154, 6th floor, Jardines en la Montaña, in Mexico City, with opening hours from Monday to Friday 9:00 am to 5:00 pm.

In addition, to be an organ donor, there is a Voluntary Donor Card, with which you can express your desire to be an organ and/or tissue donor for transplant purposes. The objective is that this card is given to a family member so that at the moment of loss of life, he/she will be the one to support your decision. You can register on the Cenatra website, where you must enter data such as name, age, CURP, address, and email.

Becoming an organ donor is free of charge in Mexico

The Mexican Government specifies that the procedures to demonstrate an interest in becoming an organ donor are free of charge, as well as if a patient is included in the waiting list to receive a transplant. "If the patient is a candidate for transplant, then, attending to the conditions established by the Mexican General Health Law, he/she will be included, free of charge in the "National Transplant Registry, through the hospital unit."