Skip to main content
SpringerLink
Log in

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

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

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

References

  1. Annual Report of the U.S. Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: transplant data 1999–2008 (2009) Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation, Rockville

  2. Klein AS, Messersmith EE, Ratner LE et al (2010) Organ donation and utilization in the United States, 1999–2008. Am J Transplant 10(4 Pt 2):973–986

    Article  PubMed  CAS  Google Scholar 

  3. Howard RJ, Schold JD, Cornell DL (2005) A 10-year analysis of organ donation after cardiac death in the United States. Transplantation 80:564–568

    Article  PubMed  Google Scholar 

  4. Bernat JL, D’Alessandro AM, Port FK et al (2006) Report of a National Conference on Donation after cardiac death. Am J Transplant 6:281–291

    Article  PubMed  CAS  Google Scholar 

  5. Tuttle-Newhall JE, Krishnan SM, Levy MF et al. (2009) Organ donation and utilization in the United States, 1998–2007. Am J Transplant (4 Pt 2):879–893. www.unos.gov. Accessed 25 Dec 2011

  6. Merion RM, Ashby VB, Wolfe RA et al (2005) Deceased-donor characteristics and the survival benefit of kidney transplantation. J Am Med Assoc 294:2726–2733

    Article  CAS  Google Scholar 

  7. McCullough KP, Keith DS, Meyer KH et al (2009) Kidney and pancreas transplantation in the United States, 1998–2007. Am J Transplant 9(4 Pt 2):894–906

    Article  PubMed  CAS  Google Scholar 

  8. Matesanz R, Marazuela R, Domínguez-Gil B et al (2009) The 40 donors per million population plan: an action plan for improvement of organ donation and transplantation in Spain. Transplant Proc 41:3453–3456

    Article  PubMed  CAS  Google Scholar 

  9. Oliver M, Woywodt A, Ahmed A et al (2011) Organ donation, transplantation and religion. Nephrol Dial Transplant 26:437–444

    Article  PubMed  Google Scholar 

  10. Vagefi PA, Ascher NL, Freise CE et al (2012) Use of living donor liver transplantation varies with the availability of deceased donor liver transplantation. Liver Transplant 18:160–165

    Article  Google Scholar 

  11. Marks WH, Wagner D, Pearson TC et al (2006) Organ donation and utilization, 1995–2004: entering the collaborative era. Am J Transplant 6:1101–1110

    Article  PubMed  CAS  Google Scholar 

  12. Howard RJ, Schold JD, Cornell DL (2005) A 10-year analysis of organ donation after cardiac death in the United States. Transplantation 80:564–568

    Article  PubMed  Google Scholar 

  13. Saidi RF, Bradley J, Greer D et al (2010) Changing pattern of organ donation at a single center; are potential brain dead donors being lost to donation after cardiac death? Am J Transplant 10:2536–2540

    Article  PubMed  CAS  Google Scholar 

  14. Feng S, Goodrich NP, Bragg-Gresham JL et al (2006) Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant 6:783–790

    Article  PubMed  CAS  Google Scholar 

  15. Merion RM, Pelletier SJ, Goodrich N et al (2006) Donation after cardiac death as a strategy to increase deceased donor liver availability. Ann Surg 244:555–562

    PubMed  Google Scholar 

  16. Saidi RF, Elias N, Kawai T et al (2007) Outcome of kidney transplantation using expanded criteria donors and donation after cardiac death kidneys: realities and costs. Am J Transplant 7:2769–2774

    Article  PubMed  CAS  Google Scholar 

  17. Axelrod DA, Schnitzler M, Salvalaggio PR et al (2007) The economic impact of the utilization of liver allografts with high donor risk index. Am J Transplant 7:990–997

    Article  PubMed  CAS  Google Scholar 

  18. Boucek MM, Mashburn C, Dunn SM et al (2008) Pediatric heart transplantation after declaration of cardiocirculatory death. N Engl J Med 359:709–714

    Article  PubMed  CAS  Google Scholar 

  19. Farney AC, Singh RP, Hines MH et al (2008) Experience in renal and extrarenal transplantation with donation after cardiac death donors with selective use of extracorporeal support. J Am Coll Surg 206:1028–1037

    Article  PubMed  Google Scholar 

  20. Moers C, Smits JM, Maathuis MH et al (2009) Machine perfusion or cold storage in deceased-donor kidney transplantation. N Engl J Med 360:7–19

    Article  PubMed  CAS  Google Scholar 

  21. Fondevila C (2010) Is extracorporeal support becoming the new standard for the preservation of DCD grafts? Am J Transplant 10:1341–1342

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Organ Transplantation, Department of Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, S6-426, Worcester, MA, 01655, USA

    Reza F. Saidi, Nicolas Jabbour, YouFu Li, Shimul A. Shah & Adel Bozorgzadeh

  2. Transplant Center, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA

    James F. Markmann & A. B. Cosimi

Authors
  1. Reza F. Saidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James F. Markmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicolas Jabbour
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. YouFu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shimul A. Shah
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. B. Cosimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Adel Bozorgzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Reza F. Saidi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saidi, R.F., Markmann, J.F., Jabbour, N. et al. The Faltering Solid Organ Donor Pool in the United States (2001–2010). World J Surg 36, 2909–2913 (2012). https://doi.org/10.1007/s00268-012-1748-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-012-1748-0

Keywords

Search

Navigation