annual increase in the number of donors over the prior year ranges from 26 additional donors (1988 to 1989) to 1,057 more donors (1999 to 2000) (OPTN, 2006). Furthermore, there has been a steady increase in the number of organs recovered (with an average of approximately 1,100 more organs recovered each year than in the previous year); 2,416 more organs were recovered in 2004 than in 2003,2 the largest recent increase (OPTN, 2006). However, the growth of the waiting list has been much more dramatic, with approximately 5,000 more candidates for transplantation each year than in the prior year (Table 2-1). The net result is a widening gap between the supply of transplantable organs and the number of patients on the waiting list—hence, the increasing need for donated organs (see Figure 1-1 in Chapter 1).
The U.S. waiting list for organ transplants, which listed 16,026 individuals in 1988, grew more than fivefold to greater than 90,000 candidates for transplantation in early 2006 (IOM, 1999; OPTN, 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 approximately 72 percent of the transplant waiting list in March 2006 (Table 2-2; Figure 2-1). As discussed in Chapter 1, the waiting list is dynamic and changes throughout the year as new transplant candidates and registrations are added, individuals receiving a transplant are removed, and other changes are made. In 2005, 44,619 transplant candidates were added, and there were 48,922 new registrations (an individual candidate can be registered at multiple centers or for more than one organ) (OPTN, 2006).
In 2005, there were 7,593 deceased donors and 6,896 living donors (OPTN, 2006). Although the first transplantation in 1954 involved a kidney from a living donor, most organ transplantations are the result of donations from deceased donors. Deceased donors provide multiple organs (for 2005, a simple calculation based on the number of transplanted organs and the number of deceased donors results in 3.06 transplanted organs per deceased donor); most living donors provide only one partial or complete organ. Of the 30,148 organs transplanted in 2005, 23,249 organs were from deceased donors and 6,899 were from living donors3 (OPTN, 2006). In 2001, the number of living donors exceeded that of deceased donors for the first time (Figure 2-2). Since then the increase in the numbers of dona-