FIGURE S-1 Growth in the number of transplants and in the number of candidates on the transplant waiting list.

waiting list for organ transplants, which listed 16,026 individual candidates for transplantation in 1988, has grown more than fivefold to greater than 90,000 in January 2006. The need for kidney transplants is the major driving force in the increase in the waiting list, with individuals waiting for a kidney transplant constituting more than 70 percent of the individuals on the current transplant waiting list. In 2005, 44,619 transplant candidates were added to the waiting list.

Over the past 10 years, minority populations have donated organs at increased rates. In the past, donation by minority populations has been hindered by mistrust of the healthcare system, inequities in access to transplantation, and failure to request donation. Although donations by minority populations are steadily increasing, several of these matters remain unresolved and need further attention. The donation rates by minority populations are now in proportion to their population distribution in the U.S. census. However, there is an increased need for transplants, particularly kidney transplants, in minority populations because of the higher incidence of end-stage renal disease among the members of these populations. In addition, there is still room for improvement in the rates of consent to organ donation among all ethnic groups.

As the demand for organ donation far exceeds the current supply of available organs, various efforts are under way to determine how best to reduce the gap between supply and demand. In addition to refinements in hospital processes and protocols, several proposals are being discussed that



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