Barriers to liver transplantation in the Arab world

Liver transplantation is a vital intervention for patients with end-stage liver disease; however, the Arab world faces significant barriers that hinder access to this life-saving procedure in terms of both practice and research. This narrative review explores the multifaceted challenges, including financial constraints, limited healthcare infrastructure, cultural factors, and the prevalence of infectious diseases. In the Arab countries, both culture and religion were found to play major roles in the acceptability of liver transplantation. High rates of misconceptions and financial strain on patients and healthcare systems necessitate more transplantation programs and improved financial coverage and insurance policies. Enhancing healthcare facilities and improving access to innovative technologies through research is essential for optimizing transplantation outcomes, considering that common diseases in the region decrease the donor pool and increase complication risks. Public health initiatives to prevent and control prevalent liver diseases, particularly hepatitis, and to manage infection risk are also critical. Stricter regulations should be enforced in less developed countries in the region along with early screening practices to address inherited blood disorders and infectious diseases. Additionally, targeted research on liver diseases specific to the Arab context is crucial, along with fostering dialogue about cultural, religious, economic, and health-related factors affecting donor and recipient eligibility. By tackling these complex barriers through targeted comprehensive strategies, the Arab world can advance to a more equitable and effective liver transplantation system, ultimately improving patient outcomes and quality of life.