Impact of wellbeing and healthcare resources on deceased liver donation in Mexico

In Mexico, the rates of donation after brain death (DBD) and the use of deceased donor livers (DDL) are low compared to other countries. We aimed to analyze the effect of the population well-being and healthcare resources of each State on donation trends and compare the States of Mexico to countries with similar characteristics. Using publicly available databases, we analyzed the number of DBD and DDL cases per million people (pmp), liver donor conversion rate (LDCR), and population and economic variables for each State between 2007 and 2023. Panel data multivariate regression analyses of the relationship between DBD pmp, DDL pmp, LDCR, and the collected variables were performed. During the study period, Mexico recorded 7233 cases of DBD, of which 2,604 DDL were recovered, corresponding to an LDCR of 33.4%. The median DBD pmp was 2.59, and the median DDL pmp was 0.073, with an LDCR of 27.02%. After adjusting for population, Mexico City showed a reduction in the difference in DBD and DDL activities compared to other States. Significant correlations were found between the LDCR and DDL pmp (r = 0.789; p < 0.001). The percentage of the population living in localities of < 5,000 inhabitants, hospital beds per 1,000 inhabitants (BPK), and total healthcare personnel had a significant impact on the DBD pmp rate, whereas BPK and the uninsured population percentage had a significant impact on DDL pmp and LDCR. DBD pmp activity in Mexico was similar to that in countries with the same BPK capacity. In conclusion, deceased liver donation in Mexico is related to local access to healthcare and availability of resources. The development and growth of organ donation in Mexico requires investment in the overall healthcare system, as well as adequate resource distribution among its States.