The potential supply of organ donors. An assessment of the efficacy of organ procurement efforts in the United States

R. W. Evans, C. E. Orians and N. L. Ascher
Battelle-Seattle Research Center, WA 98105.

OBJECTIVES--To estimate the potential supply of organ donors and to measure the efficiency of organ procurement efforts in the United States. METHODS--A geographic database has been developed consisting of multiple cause of death and sociodemographic data compiled by the National Center for Health Statistics. All deaths are evaluated as to their potential for organ donation. Two classes of potential donors are identified: class 1 estimates are restricted to causes of death involving significant head trauma only, and class 2 estimates include class 1 estimates as well as deaths in which brain death was less probable. RESULTS--Over 23,000 people are currently awaiting a kidney, heart, liver, heart-lung, pancreas, or lung transplantation. Donor supply is inadequate, and the number of donors remained unchanged at approximately 4000 annually for 1986 through 1989, with a modest 9.1% increase in 1990. Between 6900 and 10,700 potential donors are available annually (eg, 28.5 to 43.7 per million population). Depending on the class of donor considered, organ procurement efforts are between 37% and 59% efficient. Efficiency greatly varies by state and organ procurement organization. CONCLUSIONS--Many more organ donors are available than are being accessed through existing organ procurement efforts. Realistically, it may be possible to increase by 80% the number of donors available in the United States (up to 7300 annually). It is conceivable, although unlikely, that the supply of donor organs could achieve a level to meet demand.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

End-stage cardiomyopathy and secondary mitral insufficiency surgical alternative with prosthesis implant and left ventricular restoration
Buffolo et al.
Eur. J. Cardiothorac. Surg. 2006;29:S266-S271.
ABSTRACT | FULL TEXT  

Cardiac xenotransplantation: Recent preclinical progress with 3-month median survival
McGregor et al.
J. Thorac. Cardiovasc. Surg. 2005;130:844-844.
ABSTRACT | FULL TEXT  

Functional Changes After Partial Left Ventriculectomy and Mitral Valve Repair Assessed by Gated Perfusion SPECT
Schafers et al.
JNM 2004;45:1605-1610.
ABSTRACT | FULL TEXT  

The Costs of Denying Scarcity
Alexander et al.
Arch Intern Med 2004;164:593-596.
FULL TEXT  

Retrieving organs from non-heart-beating organ donors: a review of medical and ethical issues: [Prelevement d'organes chez des donneurs a coeur non battant : une revue ethique et medicale]
Doig and Rocker
Canadian J. Anesthesia 2003;50:1069-1076.
ABSTRACT | FULL TEXT  

Estimating the Number of Potential Organ Donors in the United States
Frutos et al.
NEJM 2003;349:2073-2075.
FULL TEXT  

Estimating the Number of Potential Organ Donors in the United States
Sheehy et al.
NEJM 2003;349:667-674.
ABSTRACT | FULL TEXT  

Factors Influencing Families' Consent for Donation of Solid Organs for Transplantation
Siminoff et al.
JAMA 2001;286:71-77.
ABSTRACT | FULL TEXT  

Attitudes and Practices in Postmortem Organ Procurement
Ramalingam et al.
JAMA 2001;285:1958-1960.
FULL TEXT  

ZONAL ALLOCATION FOR THORACIC ORGANS IN THE UNITED KINGDOM: HAS IT BEEN SUCCESSFUL? A SINGLE-CENTER VIEW
Aziz et al.
J. Thorac. Cardiovasc. Surg. 1999;118:733-739.
ABSTRACT | FULL TEXT  

Limits to liver transplantation in the UK
PEREIRA and WILLIAMS
Gut 1998;42:883-885.
FULL TEXT  

EARLY RESULTS WITH PARTIAL LEFT VENTRICULECTOMY
McCarthy et al.
J. Thorac. Cardiovasc. Surg. 1997;114:755-765.
ABSTRACT | FULL TEXT  

Procurement and Allocation of Solid Organs for Transplantation
Hauptman and O'Connor
NEJM 1997;336:422-431.
FULL TEXT  

Secular Trends in Cardiac Transplant Recipient and Donor Management in the United States, 1990 to 1994: A Multi-Institutional Study
Rodeheffer et al.
Circulation 1996;94:2883-2889.
ABSTRACT | FULL TEXT  

THE INFLUENCE OF CONCORDANT XENOGRAFTS ON THE HUMORAL AND CELL-MEDIATED IMMUNE RESPONSES TO SUBSEQUENT ALLOGRAFTS IN PRIMATES
Michler et al.
J. Thorac. Cardiovasc. Surg. 1996;112:1002-1009.
ABSTRACT | FULL TEXT  

ACTIVATION OF COAGULATION AND FIBRINOLYTIC PATHWAYS IN PATIENTS WITH LEFT VENTRICULAR ASSIST DEVICES
Spanier et al.
J. Thorac. Cardiovasc. Surg. 1996;112:1090-1097.
ABSTRACT | FULL TEXT  

Non-Heart-Beating Donors: A Model of Thoracic Allograft Injury
Mauney et al.
Ann. Thorac. Surg. 1996;62:54-61.
ABSTRACT | FULL TEXT  

Public Policy Governing Organ and Tissue Procurement in the United States: Results from the National Organ and Tissue Procurement Study
Siminoff et al.
ANN INTERN MED 1995;123:10-17.
FULL TEXT  

Renal Transplantation
Suthanthiran and Strom
NEJM 1994;331:365-376.
FULL TEXT