Recovery without equity: the complex post-COV ID landscape of transplantation in Mexico

Background: The COVID-19 pandemic disrupted transplant activity worldwide, particularly in Latin America.Objective: To evaluate organ donation status in Mexico 2 years after Mexican health authorities implemented the National Plan for the Reactivation of Organ Donation and Transplantation.Methods: An observational, descriptive, and retrospective study that analyzed data from the National Transplant Registry to assess trends in organ donation and transplantation during the pre-COVID (2018-2019) and post-COVID (2022-2024) periods.Results: Public sector donations decreased by 41.09%, whereas those in the private sector decreased by 26%.Kidney transplants returned to pre-pandemic levels (+1.17%).Deceased donor kidney transplants in the private sector decreased by 48.20%.Liver transplants increased by 20.51%, primarily in the public sector, with an increase of 88.88%.Heart transplants increased by 44.1%.Conclusion: Inequalities persist in the aftermath of COVID-19.The public sector faces structural challenges, and the private sector relies heavily on living donor donations.Strengthening federal coordination and public awareness initiatives is essential to sustaining growth and equity in transplant programs.