World Journal of Surgery

, Volume 36, Issue 12, pp 2909–2913

The Faltering Solid Organ Donor Pool in the United States (2001–2010)

  • Reza F. Saidi
  • James F. Markmann
  • Nicolas Jabbour
  • YouFu Li
  • Shimul A. Shah
  • A. B. Cosimi
  • Adel Bozorgzadeh
Article

DOI: 10.1007/s00268-012-1748-0

Cite this article as:
Saidi, R.F., Markmann, J.F., Jabbour, N. et al. World J Surg (2012) 36: 2909. doi:10.1007/s00268-012-1748-0

Abstract

Background

Organ shortage is the greatest challenge facing the field of organ transplantation today. Use of more organs of marginal quality has been advocated to address the shortage.

Method

We examined the pattern of donation and organ use in the United States as shown in the Organ Procurement and Transplantation Network/United Network for Organ Sharing database of individuals who were consented for and progressed to organ donation between January 2001 and December 2010.

Results

There were 66,421 living donors and 73,359 deceased donors, including 67,583 (92.1 %) identified as donation after brain death and 5,776 (7.9 %) as donation after circulatory death (DCD). Comparing two periods, era 1 (01/2001–12/2005) and era 2 (01/2006–12/2010), the number of deceased donors increased by 20.3 % from 33,300 to 40,059 while there was a trend for decreasing living donation. The DCD subgroup increased from 4.9 to 11.7 % comparing the two eras. A significant increase in cardiovascular/cerebrovascular disease as a cause of death was also noted, from 38.1 % in era 1 to 56.1 % in era 2 (p < 0.001), as was a corresponding decrease in the number of deaths due to head trauma (48.8 vs. 34.9 %). The overall discard rate also increased from 13,411 (11.5 %) in era 1 to 19,516 (13.7 %) in era 2. This increase in discards was especially prominent in the DCD group [440 (20.9 %) in era 1 vs. 2,089 (24.9 %) in era 2].

Conclusions

We detect a significant change in pattern of organ donation and use in the last decade in the United States. The transplant community should consider every precaution to prevent the decay of organ quality and to improve the use of marginal organs.

Abbreviations

DBD

Donation after brain death

DCD

Donation after circulatory death

OPTN

Organ Procurement and Transplantation Network

UNOS

United Network for Organ Sharing

ECD

Expanded criteria donor

SCD

Standard criteria donor

HRSA

Health Resources and Services Administration

CVA

Cerebrovascular accident

DSA

Donation service areas

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Reza F. Saidi
    • 1
  • James F. Markmann
    • 2
  • Nicolas Jabbour
    • 1
  • YouFu Li
    • 1
  • Shimul A. Shah
    • 1
  • A. B. Cosimi
    • 2
  • Adel Bozorgzadeh
    • 1
  1. 1.Division of Organ Transplantation, Department of SurgeryUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Transplant Center, Massachusetts General HospitalHarvard Medical SchoolBostonUSA

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