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Wide Variation Among Transplant Centers in Procuring Organ Donors

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Today, the Office of Inspector General (OIG) announces the release of a report entitled, “Variation in Organ Donation Among Transplant Centers.” The report was undertaken as part of OIG's ongoing work to provide relevant data to support the Department's efforts to raise awareness of the importance of organ donation.

In the report, the OIG found the rate of consent for donation varies widely among transplant centers in procuring organ donors at the national, regional and local levels. Documenting the variation among transplant centers will help identify centers having the potential for increasing the number of donors, a key step in closing the gap between the need for and the availability of organs.

The OIG analysis includes 190 of the nation’s 255 transplant centers and 51 of the 59 Organ Procurement Organizations (OPOs) and is based on the consent rate at each transplant center. The consent rate is the number of patients for whom consent to donate organs was given, as a percentage of all patients at the hospital who were medically eligible to donate organs. Our analysis covers a 16-month period, from August 2001 through November 2002.

The OIG found that of 190 transplant centers in our analysis, 18 had a donor consent rate below 30 percent, compared to a national average of 51 percent. Had these 18 transplant centers obtained consent at the average rate of the other 172 centers (54 percent) these centers would have realized 130 more donors beyond their current performance, resulting in an estimated additional 450 life-saving organs.

In addition to being a transplant center, there are factors that can explain some portion of this variation. For example, many of the centers with low consent rates are located in urban areas that traditionally have had difficulty in obtaining donors. However, it is important to note that overall, transplant centers have a slightly higher consent rate than do other hospitals. A primary objective of this study was not to explain these differences, but rather to identify areas in which there is broad opportunity for increasing organ donation.

At the national level, as well as within geographic regions and at the OPO service area level the rate of consent for donation varies widely among transplant centers. The data also show a slightly higher consent rate in hospitals with a larger number of transplant programs and operations. More than 80,000 Americans are currently awaiting organ transplants, yet fewer than 25,000 people received a transplant in 2002; 6,680 of these transplants were from living donors (kidneys and livers), and 18,258 were from cadaveric donors. There were 6,184 cadaveric donors in 2002, and 6,818 living donors. During that same year more than 6,400 people died while waiting for a transplant. It is estimated that 12,000 to 15,000 deaths annually could yield organs for transplantation; however, fewer than half of those deaths led to such an outcome in 2002. (Source: United Network for Organ Sharing)

For the full Inspection Report: