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An Assessment of the Efficiency of Organ Procurement Efforts in the United States

Roger W. Evans, PhD; Carlyn E. Orians, MA; Nancy L. Ascher, MD, PhD

JAMA. 1992;267(2):239-246.

Abstract
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 23000 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 10700 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.

(JAMA. 1992;267:239-246)

Author Affiliations
From the Battelle-Seattle (Wash) Research Center (Dr Evans and Ms Orians) and the Department of Surgery, University of California at San Francisco (Dr Ascher).

Footnotes
Reprint requests to Battelle-Seattle Research Center, 4000 NE 41st Street, Seattle, WA98105 (Dr Evans).

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