A scoping review of non-medical barriers to living-donor liver transplant.

Objective
To identify and categorize non-medical barriers encountered by recipient, donors, and healthcare providers in the context of living-donor liver transplantation (LDLT).Background
Liver transplantation (LT) is vital for individuals with liver failure, yet high mortality rates on the transplant waitlist persist. LDLT was introduced to address deceased-donor organ shortages, however, its adoption varies widely across regions, prompting the need to explore barriers hindering its implementation.Methods
The scoping review employed inclusion and exclusion criteria to identify studies focusing on non-medical barriers to LDLT in both adult and pediatric populations. Qualitative, quantitative, and mixed-method studies were considered, covering the period from Jan-2005 to Feb-2023. The review's search strategy was conducted in Ovid MEDLINE and Ovid EMBASE databases. Studies meeting the criteria were assessed for their characteristics and findings, which were synthesized into recipient, donor, and provider level barriers.Results
Among 2394 initially screened articles, 17 studies were eligible for inclusion. Recipient-level barriers encompassed systemic disparities in access, limited social support, immigration status and inadequate awareness of LDLT. Donor-level barriers involved surgery-related risks, recovery time concerns, financial burdens, and religious beliefs. Provider-level barriers highlighted institutional support inadequacies and specialized surgeon shortages.Conclusion
The scoping review underscores non-medical barriers to LDLT across recipient, donor, and provider levels. These barriers include socioeconomic disparities, information gaps, and inadequate institutional support. The findings underscore the need for comprehensive national efforts to raise awareness about LDLT and provide essential financial support.