Organ transplantation increases in Brazil

The number of organ transplants carried out in Brazil between January and September this year grew by 12% compared to the same period last year. The level is the highest in four years, but has not yet reached the level recorded in 2019, before the start of the coronavirus pandemic.

There were 6,559 transplants in the first nine months of 2023, compared to 5,855 in 2022. In 2019, the country had 6,722 organs transplanted in the period, including heart, liver, intestine, pancreas, lung, kidney and multivisceral.

The data is included in the Brazilian Transplant Registry, a report released this Monday (4) by the Brazilian Association of Organ Transplantation (ABTO). “Although there are some setbacks, the donation and transplant situation appears promising and we are close to the goals established for the next six years”, says the presentation text.

According to the document, most of the year’s goals for transplants have already been achieved. From January to September, the donor rate was 19.6 pmp (per million people), a level that reaches the entity’s projection for the year and which exceeds the rate recorded in 2019. The entity’s goal is for the indicator to reach to 30 pmp donors by 2028.

The indicators relating to kidney, liver and heart transplants – which together correspond to 97% of total procedures – registered an increase, with the liver transplant rate (11.4 pmp) being the highest ever obtained.

Regarding heart transplantation (2.1 pmp), “it should be noted that the rate of patients on the waiting list and admission to the list is much lower than the estimated need for transplantation (8 pmp)”, says the report. “Some possibilities could be less referral of patients to transplant centers or late referral.”

The only organs that have not yet reached the predicted volume of transplants were lung and pancreas, which were also below the previous year’s rates. “Lung transplantation is performed in a few centers, in just three states. Meanwhile, the number of pancreas transplants, which are not vital, has decreased in many countries, despite excellent results”, says the presentation text of the document, signed by doctor Valter Duro Garcia.

The document also indicates a significant increase in cornea (12,014) and bone marrow (3,062) transplants, even surpassing the 2019 records

The report, which has been produced by ABTO since 1997, also draws attention to the difference of almost 20% between effective donors (19.6 pmp) and those who had organs actually transplanted (15.9 pmp).

The discrepancy, according to Garcia, “may be partially explained by organs sent to other states and not used at destination for various reasons, such as long cold ischemia time and problems in storing or removing the organs”. There are still cases in which a contraindication is discovered after surgery to remove the organs, which prevents the transplant from being completed.

The number of patients on the waiting list for an organ is also on the rise – in September, around 60 thousand people were waiting in line.

According to the expert, Brazil still has profound regional inequalities when it comes to organ transplants. “The northern region, I would say, is 20 years behind. Donation rates were not so low, but very few transplants are carried out – there are no heart transplants, no lung transplants”, says Garcia, who says he maintains dialogue with the Ministry of Health in search of solutions to the region.

The report released this week suggests two measures: “the formation of new transplant centers in the region and changes in the technical regulations for transplants, so that kidneys generated in the Northern Region are primarily allocated to patients in that region”.

*With information from Folha de S.Paulo

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