The number of potential deceased organ donors in the United States is not expected to increase greatly over the next five years, according to a study addressing trends in medical criteria associated with potential donation. The study suggests opportunities for increasing deceased donation within existing donor potential, as well as a need for additional research to estimate donor potential more precisely.
“Given a relatively static trend in the number of potential donors, and the continued growth in demand for transplantation, healthcare professionals must challenge traditional assumptions about who may be a medically suitable donor,” said David Klassen, MD, chief medical officer of the United Network for Organ Sharing. “While that reassessment is already happening, we must expand our efforts to provide more people a chance to receive a transplant.”
Klassen shared a summary of the study’s findings with the national Advisory Committee on Organ Transplantation on March 12, 2015. UNOS conducted the study at the request of the Health Resources and Services Administration of the U.S. Department of Health and Human Services as a task of the Organ Procurement and Transplantation Network (OPTN) contract.
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The study notes that donation from older individuals may be a key focus area for increasing transplants. Among people who meet basic medical criteria for deceased donation, the actual donation rate for those 50 to 75 is considerably lower than it is for those age 18 to 34.
"Increased use of organs from older donors may represent the greatest single opportunity to increase transplantation overall,” said Klassen. “The candidates who may benefit the most from older donors are those who may survive longer with a timely transplant than they would if they continue to wait a long time for a transplant.”
Because medical criteria for determining donation potential continue to evolve, additional research is needed to refine the estimated number of potential deceased donors in the United States. While as many as 35,000 to 40,000 people each year meet basic criteria for donation, the true potential would likely be lower if more detailed medical information was available for study. In 2014, organs were recovered from nearly 8,600 deceased donors.
Based on trends in medical criteria consistent with potential donation, the study indicates the rate of potential deceased donors is expected to increase by less than one percent per year over the next several years unless there are significant, unexpected changes in U.S. population demographics.
The study’s findings offer a number of implications for clinical practice in order to realize more donation potential. These include:
- Enhancing recognition of deceased donor potential, both by referring hospitals and organ procurement organizations
- Encouraging transplant hospitals to expand medical acceptance criteria for potential donors, particularly in terms of “net benefit” (maximizing survival and quality of life through transplantation as compared to that of continuing to wait for a transplant)
- Assessing the effect of existing performance metrics for transplant centers and organ procurement organizations on their likelihood of using organs from older donors