Pediatric liver transplantation in Brazil over two decades: a scoping review

Brazil ranks second globally in absolute liver transplants and leads pediatric transplantation in Latin America. This scoping review aims to map the results and perspectives of pediatric liver transplantation in Brazil from 2000 to 2022. A scoping review was conducted following the Preferred Reporti...

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Main Authors: Julia Ribeiro Kormann, Kamila Recarcati, Mayara Mayer Alves, Ariel Pamela da Silva Lopes, José Sampaio-Neto, Izabel Cristina Meister Martins Coelho, Camila Aparecida Moraes Marques
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2025-08-01
Series:Exploration of Digestive Diseases
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Online Access:https://www.explorationpub.com/uploads/Article/A100587/100587.pdf
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author Julia Ribeiro Kormann
Kamila Recarcati
Mayara Mayer Alves
Ariel Pamela da Silva Lopes
José Sampaio-Neto
Izabel Cristina Meister Martins Coelho
Camila Aparecida Moraes Marques
author_facet Julia Ribeiro Kormann
Kamila Recarcati
Mayara Mayer Alves
Ariel Pamela da Silva Lopes
José Sampaio-Neto
Izabel Cristina Meister Martins Coelho
Camila Aparecida Moraes Marques
author_sort Julia Ribeiro Kormann
collection DOAJ
description Brazil ranks second globally in absolute liver transplants and leads pediatric transplantation in Latin America. This scoping review aims to map the results and perspectives of pediatric liver transplantation in Brazil from 2000 to 2022. A scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-ScR) guidelines, using PubMed, Virtual Health Library (VHL), and ScienceDirect. From 293 records, 26 studies were included based on predefined criteria. The review focused on clinical indications, techniques, outcomes, and regional disparities. Results: Of the 26 included studies, 10 (38%) reported survival rates, showing 1-, 5-, and 10-year survival of 89.3%, 78.1%, and 68.5% for deceased donors and 93.1%, 85.7%, and 67.5% for living donors, respectively. Eleven studies (42%) discussed living donor liver transplantation (LDLT), which accounts for 53.4% of pediatric transplants. Eight studies (31%) detailed postoperative complications, such as vascular (up to 19%) and biliary (15.7%) issues, rejection (~ 50%), and infections. The COVID-19 pandemic led to a 20.6% reduction in transplant activity and increased waiting list mortality from 8.4% to 11.9%. Despite Brazil’s leadership in pediatric liver transplants, challenges persist, including donor shortages, diagnostic delays, geographic concentration in São Paulo (66%), and limited data systematization. These factors hinder equitable access and optimal outcomes across the country. To improve pediatric liver transplantation in Brazil, actions are needed to strengthen donor registration systems, decentralize services, enhance team training, and adopt techniques like split liver transplantation. Expanding national databases and prognostic tools will help address disparities and improve care.
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spelling doaj-art-87c74231fbd24b5f8f92acc4e50cf3602025-08-22T08:08:16ZengOpen Exploration Publishing Inc.Exploration of Digestive Diseases2833-63212025-08-01410058710.37349/edd.2025.100587Pediatric liver transplantation in Brazil over two decades: a scoping reviewJulia Ribeiro Kormann0https://orcid.org/0000-0002-1046-0655Kamila Recarcati1https://orcid.org/0000-0002-9584-5174Mayara Mayer Alves2https://orcid.org/0000-0003-3778-2264Ariel Pamela da Silva Lopes3https://orcid.org/0000-0003-0632-8915José Sampaio-Neto4https://orcid.org/0000-0003-2863-2184Izabel Cristina Meister Martins Coelho5https://orcid.org/0000-0002-4904-0746Camila Aparecida Moraes Marques6https://orcid.org/0000-0001-5121-922XFaculdades Pequeno Príncipe, Curitiba 80230-020, BrazilFaculdades Pequeno Príncipe, Curitiba 80230-020, BrazilFaculdades Pequeno Príncipe, Curitiba 80230-020, BrazilFaculdades Pequeno Príncipe, Curitiba 80230-020, BrazilFaculdades Pequeno Príncipe, Curitiba 80230-020, Brazil; Hospital Pequeno Príncipe, Curitiba 80250-060, Brazil; Santa Casa de Curitiba, Curitiba 80310-030, BrazilFaculdades Pequeno Príncipe, Curitiba 80230-020, Brazil; Hospital Pequeno Príncipe, Curitiba 80250-060, BrazilFaculdades Pequeno Príncipe, Curitiba 80230-020, BrazilBrazil ranks second globally in absolute liver transplants and leads pediatric transplantation in Latin America. This scoping review aims to map the results and perspectives of pediatric liver transplantation in Brazil from 2000 to 2022. A scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist (PRISMA-ScR) guidelines, using PubMed, Virtual Health Library (VHL), and ScienceDirect. From 293 records, 26 studies were included based on predefined criteria. The review focused on clinical indications, techniques, outcomes, and regional disparities. Results: Of the 26 included studies, 10 (38%) reported survival rates, showing 1-, 5-, and 10-year survival of 89.3%, 78.1%, and 68.5% for deceased donors and 93.1%, 85.7%, and 67.5% for living donors, respectively. Eleven studies (42%) discussed living donor liver transplantation (LDLT), which accounts for 53.4% of pediatric transplants. Eight studies (31%) detailed postoperative complications, such as vascular (up to 19%) and biliary (15.7%) issues, rejection (~ 50%), and infections. The COVID-19 pandemic led to a 20.6% reduction in transplant activity and increased waiting list mortality from 8.4% to 11.9%. Despite Brazil’s leadership in pediatric liver transplants, challenges persist, including donor shortages, diagnostic delays, geographic concentration in São Paulo (66%), and limited data systematization. These factors hinder equitable access and optimal outcomes across the country. To improve pediatric liver transplantation in Brazil, actions are needed to strengthen donor registration systems, decentralize services, enhance team training, and adopt techniques like split liver transplantation. Expanding national databases and prognostic tools will help address disparities and improve care.https://www.explorationpub.com/uploads/Article/A100587/100587.pdfliver transplantationpediatricstransplantation in brazilhealth sciences educationmedical education
spellingShingle Julia Ribeiro Kormann
Kamila Recarcati
Mayara Mayer Alves
Ariel Pamela da Silva Lopes
José Sampaio-Neto
Izabel Cristina Meister Martins Coelho
Camila Aparecida Moraes Marques
Pediatric liver transplantation in Brazil over two decades: a scoping review
Exploration of Digestive Diseases
liver transplantation
pediatrics
transplantation in brazil
health sciences education
medical education
title Pediatric liver transplantation in Brazil over two decades: a scoping review
title_full Pediatric liver transplantation in Brazil over two decades: a scoping review
title_fullStr Pediatric liver transplantation in Brazil over two decades: a scoping review
title_full_unstemmed Pediatric liver transplantation in Brazil over two decades: a scoping review
title_short Pediatric liver transplantation in Brazil over two decades: a scoping review
title_sort pediatric liver transplantation in brazil over two decades a scoping review
topic liver transplantation
pediatrics
transplantation in brazil
health sciences education
medical education
url https://www.explorationpub.com/uploads/Article/A100587/100587.pdf
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