Organ Donation and Utilization in the United States: 1998–2007

TLDR

Organ transplantation is the sole life‑saving therapy for many organ‑failure patients, and the national transplant environment has evolved with increased regulatory oversight and new provider requirements. This year saw changes in organ preservation techniques driven by expanded acceptance criteria and rising numbers of expanded‑criteria and donation‑after‑cardiac‑death donors. Despite a modest 67 % rise in deceased donors and a decline in living donors, use of DCD and ECD organs increased, new safety measures were introduced via DonorNet, yet national targets for conversion rates, organs per donor, DCD share, and volume growth remain unmet, though some donation service areas have exceeded them.

Abstract

Organ transplantation remains the only life-saving therapy for many patients with organ failure. Despite the work of the Organ Donation and Transplant Collaboratives, and the marked increases in deceased donors early in the effort, deceased donors only rose by 67 from 2006 and the number of living donors declined during the same time period. There continue to be increases in the use of organs from donors after cardiac death (DCD) and expanded criteria donors (ECD). This year has seen a major change in the way organs are offered with increased patient safety measures in those organ offers made by OPOs using DonorNet. Unfortunately, the goals of 75% conversion rates, 3.75 organs transplanted per donor, 10% of all donors from DCD sources and 20% growth of transplant center volume have yet to be reached across all donation service areas (DSAs) and transplant centers; however, there are DSAs that have not only met, but exceeded, these goals. Changes in organ preservation techniques took place this year, partly due to expanding organ acceptance criteria and increasing numbers of ECDs and DCDs. Finally, the national transplant environment has changed in response to increased regulatory oversight and new requirements for donation and transplant provider organizations.