Distribuição de centros de transplante de órgãos no Brasil: desigualdade regional e impacto na fila de espera – 2023

Abstract

Introduction: Brazil has the largest public organ, tissue, and cell transplant program in the world, providing free access to the entire population through the Unified Health System (SUS). However, due to high demand and the uneven distribution of transplant centers across the country, the waiting list remains extensive. This creates a significant public health issue. Objective: To highlight regional disparities in the distribution of transplant centers in Brazil and to reflect on their impact on the organ transplant waiting list. Materials and Methods: This is a cross-sectional observational analytical study based on secondary data analysis from regional reports in 2023. The data includes the number of transplants performed and waiting list statistics from the General Coordination of the National Transplant System, under the Ministry of Health. Results: In 2023, Brazil had 1.198 transplant centers and performed 9.255 procedures [1]. The Southeast and South regions accounted for 54,7% and 21,5% of all transplants, respectively, hosting 798 of these centers [2]. Meanwhile, the Northeast, Central-West, and North regions performed 16,9%, 5,4%, and 1,5% of transplants, with a total of 400 centers [2]. Regarding waiting times, they vary depending on the organ to be transplanted, ranging from one year (liver) to three years (kidney) [3]. As for the waiting list, in 2023, approximately 68.415 patients were waiting for an organ transplant in Brazil, with around 50.000 of them located in the South and Southeast regions due to the referral system established by SUS [3]. Conclusions: The Northeast, Central-West, and North regions, which have just over 23% of Brazil's transplant centers, experience excessive demand. As a result, patients are referred to regions with a higher concentration of these centers, particularly the South and Southeast, which house over 75% of the country's transplant facilities. This leads to an increased waiting list in major transplant hubs in the South and Southeast, prolonging the time required to undergo the necessary procedures. However, this referral system does not effectively reduce the waiting list in less-served regions, as the number of transplant centers there remains insufficient to meet demand.

Keywords: Transplant centers; Organ transplantation; Regions; Waiting list.