The United States liver donor population in the 1990s: A descriptive, population-based comparative study

Ian M. Gralnek, Honghu Liu, Martin F. Shapiro, Paul Martin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1019-1023
Number of pages5
JournalTransplantation
Volume67
Issue number7
DOIs
StatePublished - Apr 15 1999
Externally publishedYes

Fingerprint

Tissue Donors
Liver
Population
Cerebrovascular Trauma
Demography
Gunshot Wounds
Tissue and Organ Procurement
Homicide
Censuses
Craniocerebral Trauma
Liver Transplantation
Cause of Death
Stroke
Economics
Mortality

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

The United States liver donor population in the 1990s : A descriptive, population-based comparative study. / Gralnek, Ian M.; Liu, Honghu; Shapiro, Martin F.; Martin, Paul.

In: Transplantation, Vol. 67, No. 7, 15.04.1999, p. 1019-1023.

Research output: Contribution to journalArticle

Gralnek, Ian M. ; Liu, Honghu ; Shapiro, Martin F. ; Martin, Paul. / The United States liver donor population in the 1990s : A descriptive, population-based comparative study. In: Transplantation. 1999 ; Vol. 67, No. 7. pp. 1019-1023.
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abstract = "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.",
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