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To the Editor: The JAMA Patient Page on organ donation by Ms Stevens and colleagues¹ states "[r]ecipients of organs are chosen by severity of illness, time spent on a waiting list, and medical factors, not by economic or celebrity status." We believe that this statement is misleading.

Although it is true that economic status is not a factor in organ allocation once a potential recipient is on the waiting list, there are economic barriers to being placed on the waiting list.² For patients of low socioeconomic status, including the uninsured, such barriers can occur at many steps³ and thereby lead to lower likelihood of receiving a transplant.

Financial Disclosures: None reported.

Mark H. Drazner, MD, MSc
mark.drazner@utsouthwestern.edu

Louise P. King, JD, MD
University of Texas Southwestern Medical Center
Dallas

1. Stevens LM, Lynm C, Glass RM. JAMA Patient Page: organ donation. JAMA. 2008;299(2):244. FREE FULL TEXT 2. Institute of Medicine. Organ Procurement and Transplantation: Assessing Current Policies and the Potential Impact of the DHHS Final Rule. Washington, DC: National Academy Press; 1999:41.3. Alexander GC, Sehgal AR. Barriers to cadaveric renal transplantation among blacks, women, and the poor. JAMA. 1998;280(13):1148-1152. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;299(21):2512.