TY - JOUR
T1 - The United States liver donor population in the 1990s
T2 - A descriptive, population-based comparative study
AU - Gralnek, Ian M.
AU - Liu, Honghu
AU - Shapiro, Martin F.
AU - Martin, Paul
PY - 1999/4/15
Y1 - 1999/4/15
N2 - Background. Orthotopic liver transplantation in the United States is primarily limited by a shortage of donor organs. Methods. To better understand the low rates of organ donation in the United States and identify areas for potential improvement, we analyzed detailed demographic and mortality-specific data from 10,689 adult cadaveric liver donors obtained from the United Network for Organ Sharing from April 1, 1994 to March 31, 1997. Comparative U.S. population demographic and economic data were obtained from the U.S. census. Results. As compared with the U.S. population, we found there to be significantly fewer nonwhite (P=0.001) and foreign-born donors (P=0.001); 58.9% of liver donors were male (P=0.001). The mean age was 40.6 years; yet during the 3-year period analyzed, there was a significant trend toward increasing age of donors. Median household income was 18% to 32% lower in the donor population than in the general U.S. population. In 91.2% of cases, the donor cause of death was listed as cerebrovascular stroke or head trauma. Numerous significant interracial differences were found in both the donor mechanism and circumstance of death. These included black donors being more likely to have gunshot wound as the listed mechanism of death (P=0.001) and to have homicide as the listed circumstance of death (P=0.001). Conclusions. Nonwhites and foreign-born individuals are significantly underrepresented in the U.S. liver donor population. Furthermore, donors seem to be poorer than the general U.S. population. Increasing the liver donor pool, especially among minorities, will require creative and thoughtful public initiatives.
AB - Background. Orthotopic liver transplantation in the United States is primarily limited by a shortage of donor organs. Methods. To better understand the low rates of organ donation in the United States and identify areas for potential improvement, we analyzed detailed demographic and mortality-specific data from 10,689 adult cadaveric liver donors obtained from the United Network for Organ Sharing from April 1, 1994 to March 31, 1997. Comparative U.S. population demographic and economic data were obtained from the U.S. census. Results. As compared with the U.S. population, we found there to be significantly fewer nonwhite (P=0.001) and foreign-born donors (P=0.001); 58.9% of liver donors were male (P=0.001). The mean age was 40.6 years; yet during the 3-year period analyzed, there was a significant trend toward increasing age of donors. Median household income was 18% to 32% lower in the donor population than in the general U.S. population. In 91.2% of cases, the donor cause of death was listed as cerebrovascular stroke or head trauma. Numerous significant interracial differences were found in both the donor mechanism and circumstance of death. These included black donors being more likely to have gunshot wound as the listed mechanism of death (P=0.001) and to have homicide as the listed circumstance of death (P=0.001). Conclusions. Nonwhites and foreign-born individuals are significantly underrepresented in the U.S. liver donor population. Furthermore, donors seem to be poorer than the general U.S. population. Increasing the liver donor pool, especially among minorities, will require creative and thoughtful public initiatives.
UR - http://www.scopus.com/inward/record.url?scp=0033561393&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033561393&partnerID=8YFLogxK
U2 - 10.1097/00007890-199904150-00014
DO - 10.1097/00007890-199904150-00014
M3 - Article
C2 - 10221487
AN - SCOPUS:0033561393
VL - 67
SP - 1019
EP - 1023
JO - Transplantation
JF - Transplantation
SN - 0041-1337
IS - 7
ER -