The Journal of surgical research · 2026
Status, Advances, and Challenges in Pediatric Liver Transplantation in Africa: A Scoping Review.
СтатьяScoping ReviewНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Kasagga Brian, Thaimye Joseph, Lawal Daniel, Jacks Boma Esther, Okonkwo Benjamin Chukwunonso, Nwanna-Nzewunwa Obieze
Аннотация
INTRODUCTION: Pediatric liver diseases are a significant mortality burden in low-income countries particularly in Africa, where access to life-saving pediatric liver transplantation (PLT) is limited. We aimed to determine the current state of PLT in Africa based on the available literature, identify key barriers to access, and propose solutions.
METHODS: We conducted a comprehensive search of peer-reviewed articles, reports, and gray literature from databases such as Google Scholar, PubMed Central, Web of Science, and African Journal Online. We included studies on PLT between January 2000 and July 2024. Data were extracted, collated, and summarized following the Arksey, O'Malley, and Joanna Briggs Institute frameworks.
RESULTS: Only two African countries have PLT programs, located in South Africa and Egypt. Approximately 548 PLTs were performed, with 388 in South Africa and 160 in Egypt. Biliary atresia is the leading indication (43.1%). Sixty-six percent of patients wait longer than a year for a transplant. Living donors are predominantly used, with deceased donor programs primarily located in South Africa. Compared to global 1-y and 5-y survival rates of 86.6% and 77.7%, survival in Africa is at 79.4% and 67.4%, respectively. PLT complications include biliary (41%), vascular (16%), and enteric (10%). Major challenges include limited access and infrastructure, donor shortages, late referrals, diagnostic delays, financial and socioeconomic barriers, clinical and postoperative complications, and policy bottlenecks.
CONCLUSIONS: PLT in Africa has limited access and poorer outcomes compared to global trends. Addressing these requires increasing resources, improved early diagnosis, expanded deceased donor programs, policy development, education, and resource allocation.
METHODS: We conducted a comprehensive search of peer-reviewed articles, reports, and gray literature from databases such as Google Scholar, PubMed Central, Web of Science, and African Journal Online. We included studies on PLT between January 2000 and July 2024. Data were extracted, collated, and summarized following the Arksey, O'Malley, and Joanna Briggs Institute frameworks.
RESULTS: Only two African countries have PLT programs, located in South Africa and Egypt. Approximately 548 PLTs were performed, with 388 in South Africa and 160 in Egypt. Biliary atresia is the leading indication (43.1%). Sixty-six percent of patients wait longer than a year for a transplant. Living donors are predominantly used, with deceased donor programs primarily located in South Africa. Compared to global 1-y and 5-y survival rates of 86.6% and 77.7%, survival in Africa is at 79.4% and 67.4%, respectively. PLT complications include biliary (41%), vascular (16%), and enteric (10%). Major challenges include limited access and infrastructure, donor shortages, late referrals, diagnostic delays, financial and socioeconomic barriers, clinical and postoperative complications, and policy bottlenecks.
CONCLUSIONS: PLT in Africa has limited access and poorer outcomes compared to global trends. Addressing these requires increasing resources, improved early diagnosis, expanded deceased donor programs, policy development, education, and resource allocation.