Improved Procurement Could More Than Double Availability Of Life-saving Transplant Organs

Even though the need for transplantable organs far outweighs the supply, the number of organs donated could be more than doubled--saving thousands of lives every year--if the procurement process were improved. These findings by researchers from Harvard Medical School, Boston University, and the Institute for Healthcare Improvement appear in the summer issue of Health Care Financing Review published this week.

Although millions of people across the country are registered donors, only two percent of them annually suffer brain death and meet the other medical requirements for being a cadaveric donor. The U.S. Department of Health and Human Services (HHS) suggests that the number of actual donors may be further limited by organ procurement organizations (OPOs) that do not utilize the most efficient practices.

"We needed to know if we have a supply of potential donors who can meet the demand for organs," said Edward Guadagnoli, first author on the study and an associate professor of health care policy at Harvard Medical School. "We didn't know until we used a statistical model to estimate that number." The researchers determined that the number is about 17,000 potential donors each year.

OPOs coordinate the organ donation process and match potential donors to recipients. They also deal directly with the potential donor's family to get consent for donation. Organ donation usually comes at a difficult time for families, and the way an OPO addresses the situation can mean the difference between saving a life through transplantation and losing a potential donor. Family resistance to organ donation is the primary reason that potential donors do not donate.

According to the study, OPOs have an efficiency rate of between 20 and 80 percent, with an average rate of about 34 percent. In other words, the country's medical industry is using only one third of the potential donors.

Even with 100 percent OPO efficiency, Guadagnoli says, there still would not be enough potential donors to supply the current demand for organs.

"There are simply not enough. We figure there are about 17,000 potential donors a year, but the current need is too great. Every year, the number of people waiting increases," Guadagnoli says.

On September 9 and 10, HHS led the first of three seminars focused on increasing the number of actual donors. HHS Secretary Tommy Thompson is calling for OPOs to increase their efficiency to 75 percent, a goal that Guadagnoli says is high, but may be possible.

Other organ sources include living donors and xenotransplantation--the transplantation of an animal organ into a human. Yet cadaveric donations still provide almost 75 percent of transplanted organs. Guadagnoli says there is nothing on the medical horizon that can replace or significantly supplement this organ source.