New Research Disputes Commonly Held Beliefs About Organ Donation

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Jill Chadwick

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           More than 123,000 Americans are currently waiting for lifesaving organ transplants, but 21 patients die each day because there aren’t enough organs to go around. New research published in the recent issue of the American Journal of Transplantation shows wide variation in the number of eligible organ donors whose loved ones consent to organ donation across the country.  Doctors at The University of Kansas Hospital and the Perelman School of Medicine at the University of Pennsylvania teamed up to take a closer look at organ donor consent rates across the country.

            The findings are remarkable and dispute the commonly held notion that the gap in donor supply in certain geographic areas is due to large populations of racial and ethnic minorities who are less likely to consent for donation. The study’s lead author, David Goldberg, MD, MSCE, an assistant professor in the division of Gastroenterology at Penn said, “Instead, the data clearly shows wide variation in donation rates across regions and among white donors as well.”

            Among the more interesting findings is the fact that organ donation rates overall among potential deceased donors are lowest in New York (65%-70%), and when compared to other parts of the country (85%-90%), are among the lowest for every racial/ethnic category.   Among whites ages 18-39, it is 70-75% in New York, compared to 88-92% in highest areas.

            "With more than 10,000 patients a year dying of liver, kidney, heart or lung failure before they get their life saving opportunity these data highlight that hundreds of more patients each year can be saved" said senior author Richard Gilroy, MD, Medical Director of Liver Transplantation at The University of Kansas Hospital. "And it could be a friend, a family member or you waiting as diseases needing transplant have no cultural, regional or class boundaries. To increase organ donation it will require every hospital, every transplant center, every OPO and every community to work together. And remember that the enemy of excellent is good enough".

 EDITORS/PRODUCERS: Raw video/audio interviews with Drs. Goldberg(1st) and Gilroy(2nd), plus raw TV friendly transplant video are available for use by all news outlets. Go to the Medical News Network or copy and paste www.medicalnewsnetwork.org to download video or audio files found in “Trending Stories” to create your own news reports.

          AUTHORS’ NOTE: If consent rates over five and a half years in the geographic areas with the lowest consent rates were to increase to the current level of the geographic area with the median level of donors identified, there could potentially be 773 more donors available. That pool could yield nearly 2,700 lifesaving kidney, liver, lung, heart, pancreas, and/or intestine transplants.

 Research Methodology and Overall Findings:  The researchers examined data from the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS), the nation’s organ transplant network, on all reported “eligible deaths,” – defined as potential brain-dead organ donors age 70 years or less without any medical conditions precluding donation – from 2008 to 2013. Of 52,571 eligible patient deaths reported to UNOS, consent for donation was obtained in 73 percent of cases. Consent rates were highest among potential donors under the age of 55, patients of white race, and when the referral from the local hospital was made in a “timely” manner.    Consent rates along racial lines echoed findings from earlier studies: lower among African Americans, Hispanics, and Asians, when compared to Caucasian patients. Yet these lower consent rates among racial and ethnic minorities did not explain the overall geographic variability in consent rates.  Even after accounting for patient and geographic factors of the potential donors, the study found that the donor consent rates among the 58 donor service areas (DSA) ranged from 64 percent to 90 percent.  Although the average consent rate within each donor service area, when accounting for the race/ethnicity and other factors among the eligible deaths, was between 75 and 80 percent, the consent rates fell below 70 percent in nearly a quarter of the donor service areas when examining only one racial group at a time, the researchers found wide variation in donation rates across the nation’s donor service areas: consent rates among Caucasian patients, for example, ranged from 72 to 92 percent across the 58 donor service areas.