Wednesday, January 22, 2020

Alex Chan on deceased organ donation policy, in JAMA

Alex Chan comments on an earlier article in JAMA:
US Organ Donation Policy
Alex Chan, January 21, 2020

"To the Editor Ms Glazier and Mr Mone touted the success of the current opt-in organ donation system and argued for focusing on increasing registered donors to 75% of the adult population.1 A challenge is the intrinsic difficulty of such a task: more coordinated promotional efforts and new incentives like giving registered donors priority on organ waiting lists would likely be required.

"Even if such an increase in donor registration is possible, another challenge is the extent to which transplant centers recover organs from registered donors. Although the number of registered donors is more than half of the US population, only 36.3% of possible donors become actual donors.2 This loss of approximately one-third of registered donors suggests that obstacles to recovery of organs, such as family objection, transplant center rejections of imperfect organs, and OPO performance, are pivotal. Anecdotal evidence suggests that rejections of imperfect organs account for approximately 10% to 20%,2 leaving 10% to 20% of the loss still unaccounted for. Family consent or its lack may be a big part of the gap.
"Furthermore, 2 of the 3 states with the highest donor registration rates (Montana, 93%; Washington, 89%) have lower-than-average actual donation rates,1,2 but states like Nevada and Pennsylvania with registration rates lower than 50% have actual donation rates much higher than the national average.2 This suggests that registration is only part of the solution, and the ability of OPOs to obtain family consent and convert registrations into donations can bound the effectiveness of the current system."

Here's the earlier post, about the article on which Alex is commenting

Wednesday, August 14, 2019

No comments: