title: Creation of a solid organ transplant program in an underdeveloped country: Mexico's General Hospital transplantation program.
abstract: BACKGROUND
  With a population of >112 million persons, all Mexicans are entitled to receive medical care by the state and more than half have limited access to healthcare. From January 1985 to March 2009, 40 renal transplants were performed from living donors with a high percentage of complications. In April 2009, a new Solid Organ Transplantation Program was started; herein, we present this enterprise to the international community and briefly present a perspective on the Mexican transplant situation.
  
  
  METHODS
  We performed a retrospective chart review of kidney and liver transplant recipients from April 2009 to November 2011, including demographic features, immunosuppression, complications as well as initial and 1 month function.
  
  
  RESULTS
  We performed 68 kidney (59 living and 9 deceased donors) and 5 liver transplants (cadaveric donors). The kidney transplant recipients were 73.5% males and showed an overall mean age of 29.77 years (range, 18-60). The donor mean age was 34.08 years. Mean recipient creatinine pretransplant was 13.32 mg/dL, while at day 5 it was 2.33 and at month one, 1.32 mg/dL. Five grafts were lost (7.3%): 4 due to death with a functioning graft and 1 due to acute pyelonephritis. Five patients experienced delayed graft function Basiliximab induction was required in all but one who received thymoglobulin owing to a high panel reactive antibody. Maintenance therapy included a calcineurin inhibitor, mycophenolate mofetil (MMF), and prednisone. Liver transplant recipients were 83.6% women. The etiologies were alcoholic cirrhosis (n = 2), primary billiary cirrhosis (n = 1) and hepatitis C virus infection (n = 2). Complications included: reperfusion syndrome (n = 1), convulsive crisis (medication; n = 1), acute respiratory distress syndrome (n = 1), and death (n = 1). Their Model for End-Stage Liver Disease scopes were 10-21. After basiliximab induction, they had maintenance therapy with tacrolimus, MMF, and steroids. The donor mean age was 26.2 years. All survivors show normal liver function tests currently.
  
  
  CONCLUSIONS
  From 1985 to 2009, 40 kidney transplants were performed, with multiple complications including donor deaths. Our current results were comparable to international standards, with <15% complication rate.
authors.affiliation: Department of Transplantation and Organ Donation, Mexico's General Hospital, "Dr. Eduardo Liceaga", Mexico City, Mexico. asfa@live.com.mx
authors.forename: L
authors.initials: L
authors.lastname: García Covarrubias
authors.forename: A
authors.initials: A
authors.lastname: Rossano García
authors.forename: A
authors.initials: A
authors.lastname: Cicero Lebrija
authors.forename: A
authors.initials: A
authors.lastname: Luque Hernández
authors.forename: H
authors.initials: H
authors.lastname: Hinojosa Heredia
authors.forename: D
authors.initials: D
authors.lastname: Fernández Ángel
authors.forename: J
authors.initials: J
authors.lastname: Córdova
authors.forename: A
authors.initials: A
authors.lastname: García Covarrubias
authors.forename: R
authors.initials: R
authors.lastname: Bautista Olayo
authors.forename: H S
authors.initials: HS
authors.lastname: Diliz Perez
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D005260:Female; D006769:Hospitals, General / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008800:Mexico; D008875:Middle Aged; D016377:Organ Transplantation; D055815:Young Adult