FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

LACK OF ORGAN DONORS CAUSES 3,000 NEEDLESS DEATHS A YEAR

Question: I am on the waiting list for a kidney transplant. I don't think most people are aware of the tremendous shortage of donated organs. Would you write about donating organs in your column?

Answer: Most of us don't think of our organs as potential gifts of life, but the truth is that thousands receive a "new lease on life" each year because of the thoughtfulness of an organ donor. Unfortunately, as this reader reminded us, there is a considerable gap between the need for organs and the supply. As of January 1996, there were at least 44,167 people waiting for donor organs, and 31,157 of them were awaiting kidneys. The other 13,010 needed hearts, livers, lungs or other transplantable organs.

In 1994, the most recent year for which I could find complete statistics, there were 10,622 Americans who had kidney transplants and 6,710 who had transplants of other organs. That represents 17,332 individuals whose lives were saved and families gladdened by these gracious gifts. In the most common of these, kidney transplants, the donor can be a living person, often a relative. In most other cases, however, the family of the donor has just suffered a loss and finds comfort in the knowledge that the transplanted organ is helping another person live a healthier, longer life.

Unfortunately, in 1994 there were 3,097 individuals who died while waiting for a suitable organ. This means there is about a 15 percent chance that someone needing a transplant will die before a properly matched organ becomes available.

In this country, the decision to donate one's organs is totally voluntary and done without compensation. Efforts to increase organ donation have, to date, been mostly educational efforts directed to making people aware of the need. These have produced only a very modest increase in donations.

Studies have been done to identify why the rate of organ donation is low. A carefully done research paper was published in the November 25, 1996, issue of the Archives of Internal Medicine. I was surprised by the reasons some individuals, particularly many African Americans, give for not signing up as donors. The subjects in this study didn't trust the medical community and believed that the organs would not be allocated in a fair manner. Most thought they would go to Caucasians with money, power, and fame first. Those who fall lower in our country's ill-defined class ranking, the study participants felt, would only get the leftovers.

These are not concerns of an isolated few, but rather, were common beliefs expressed in discussion groups held in Boston, Atlanta, Kansas City, Phoenix and Seattle. The "non-donor" individuals tend to have long-held negative attitudes regarding community institutions in general and organized medicine in particular.

In my opinion, these concerns are unfounded and must be overcome if we are to make organ transplantations more available to all those who need them. Organs are allocated on the basis of tissue typing and the severity of the recipient's organ failure. Race, money and fame are not part of the equation! Offering financial or other incentives for organ donation have been considered and generally rejected. Appealing to the altruistic nature of organ donors seems to be the preferred method of encouraging giving so far. All that being said, I hope a kidney that matches your tissue chemistry will become available for you soon.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.