the inability to use approximately 40 percent of the rejected kidneys, whereas clinical judgment decisions result in the inability to use an additional 25 percent (Delmonico et al., 2005). The utilization of other organs varies; hearts are the most highly utilized with only 1 percent not transplanted after recovery. About 4 percent of recovered livers were not transplanted, primarily because of biopsy results (Delmonico et al., 2005). In some situations, organs are recovered before the intended recipients are located. This occurs more often with kidneys and pancreata (because of the organ’s potential to withstand a longer time between recovery and transplantation); heart and lung transplantations generally occur at the time of recovery (Ojo et al., 2004). Further research is needed on the early identification of organs that are not eligible for transplantation. Improvements in the coordination of the recovery and transplant efforts are also needed.

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 (Table 2-4). However, there is an increased need for trans-

TABLE 2-4 Organ Donation, Transplantation, and Waiting List by Ethnicity

Ethnicity

Population Distribution (%)a

Percentage of Total Donations, 2005b

Percentage of Transplant Recipients, 2005c

Waiting List Distribution (%) as of March 24, 2006

White

75.1

68.9

63

49.3

African American

12.3

14

18.5

27.4

Hispanic

12.5

13.2

12

15.8

Asian

3.6

2.6

4.0

5.5

American Indian/ Native Alaskan

0.9

0.5

0.7

0.9

Pacific Islander

0.1

0.1

0.4

0.5

Multiracial

2.4

0.7

0.7

0.6

aU.S. Census Bureau data, 2001. The population distribution adds up to more than 100 percent because of the option in the 2000 census to select multiple categories to accurately describe one’s ethnicity.

bIncludes deceased and living donors.

c0.7 percent of transplant recipients are of unknown ethnicity.

SOURCE: OPTN (2006); U.S. Census Bureau (2001).



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