title: Review of developments in corneal transplantation in the regions of Brazil - Evaluation of corneal transplants in Brazil.
abstract: The aim of this study was to identify inequalities in corneal donation and transplantation among the regions of Brazil. A transversal and retrospective study was specifically conducted using data from the Brazilian Transplant Registry collected by the Brazilian Association of Organ Transplantation between January 2002 and December 2014. The collected data were processed using descriptive statistical methods, and p<0.05 was the rate of rejection of the null hypothesis. From 2002 to 2014, there was an increase in the absolute number of corneal transplants, the annual rate of transplants per million people and the percentage of needed transplants performed in each of the five regions of Brazil. Family refusal and medical contraindication were the most frequent reasons for a lack of corneal donation. Although remarkable progress has been made in the last decade in each of the five Brazilian regions, health professionals' lack of preparation to approach families with donation requests at the death of a family member appears to be the main obstacle to increasing the number of corneal donations. Thus, the present study suggests the implementation of public policies to make corneal transplants more effective, particularly given that there are considerable disparities in the effectiveness with which regional needs are met and in health professionals' ability to perform transplants among the Brazilian regions, with higher rates in the South, Southeast and Midwest regions and lower rates in the North and Northeast regions.
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Oftalmologia, São Paulo/SP, Brazil.
authors.forename: Hirlana Gomes
authors.initials: HG
authors.lastname: Almeida
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Oftalmologia, São Paulo/SP, Brazil.|Santa Casa de São Paulo, Departamento de Oftalmologia, São Paulo/SP, Brazil.
authors.forename: Richard Yudi
authors.initials: RY
authors.lastname: Hida
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Oftalmologia, São Paulo/SP, Brazil.
authors.forename: Newton
authors.initials: N
authors.lastname: Kara
mesh_terms: D001938:Brazil; D016039:Corneal Transplantation / Q000706:statistics & numerical data* / Q000639:trends; D003430:Cross-Sectional Studies; D005190:Family; D054625:Healthcare Disparities / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D014850:Waiting Lists