Long waiting times for donor organs have led many people to seek alternatives, some of which have raised ethics questions. One example in the United States is a members-only organ-sharing "club" in which people who pledge to donate organs get preferred access to donations from other members. Internationally, there have been reports of people buying organs from live donors.
The UF research evaluated data from 1995 to 2000 on almost 109,000 patients from a national transplant database, using characteristics thought to have the greatest impact on patient survival: waiting time, past performance of a center in terms of patient death rates, proportion of non-ideal donors and number of deceased-donor transplants a center does a year.
Waiting time had the strongest effect on survival once a patient got on a transplant list. At centers with the longest wait times, patients' risk of death was a third higher than at those with the shortest waits.
Centers that had the highest proportions of donors considered high-risk because of age, cause of death, history of hypertension, or certain clinical measurements, had a slight elevation in death rates.
Past center performance, in terms of historical death rates, also had a slight positive effect on survival.
Contrary to expectations, the number of transplants a center does a year was not associated with patient survival. In general, high-volume centers are thought to have greater expertise, resources and facilities. But that seems a less important consideration for people who are still waiting to receive an organ.
"Maybe it does have some degree of benefit if you do reach the transplant episode, but many candidates don't," Schold said.
Waiting times and other information about transplant centers are available
|Contact: Czerne M. Reid|
University of Florida