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The recent string of announcements about advances in organ transplantation, which could radically reduce the disparity between available organs and patients who need them, couldn’t come at a better time. The Richmond, VA-based United Network for Organ Sharing (UNOS), the organization responsible for maintaining the organ procurement and transplantation network for the federal government, stated in March that the national waiting list surpassed an unprecedented 75,000 mark. The magnitude of the organ shortage is sobering, says Patricia Adams, MD, president of the organization.
"Of those 75,000 men, women, and children, probably less than a third will get the transplant they need this year," adds Adams. In fact, a decade ago, the difference between the number of transplants and the number of patients listed was less than 5,000, according to UNOS data. (See table.)
Patients on the U.S. Waiting List at Year End: 1990-2000
Transplants Performed in the U.S. 1990-2000
|Source: United Network for Organ Sharing, Richmond, VA.|
But Department of Health and Human Services (HHS) Secretary Tommy Thompson already is taking strides at reducing the wide disparity among organ donors and those who need organs. As governor of Wisconsin, Thompson helped increase organ donation levels, and his views on how to distribute donated organs were greeted with skepticism by some health care providers when he joined President Bush’s cabinet.
The HHS campaign focuses on donation rather than distribution and hopes to lure businesses and unions into promoting organ donation. Called Workplace Partnership for Life, the program already is being touted by Thompson, who encourages audiences at speaking engagements to sign organ donor cards. The program’s goal is to increase participation in organ, blood, marrow, and tissue donations.
HHS is asking Congress for an additional $5 million in funding for organ dona-tion next year, which is a 33% boost for the department. And the donation initiative comes on the heels of the announcement that HHS is introducing a national donor card that will enable transplant coordinators to proceed with donations when family members are reluctant. The national donor card would be a legal document with more weight than driver’s licenses or unofficial donor cards.
"With employers and employees working together, we can literally save thousands of lives," Thompson said in a statement. "This includes not only large corporations and unions, but also the local employer and the small staff of employees. Everyone has a contribution to make."
Nearly 20 companies and organizations already have signed on, including Aetna, General Motors, DaimlerChrysler, Ford Motor Co., Verizon, 3M, the U.S. Postal Service, and the United Auto Workers. A new web site (www.organdonor.gov) will provide ideas on how to encourage organ donation and chronicle efforts at increasing organ donor levels.
The HHS initiative also includes reviewing the potential of a national organ donor registry, creating a national medal to honor the families of organ donors, and developing a model curriculum on donation for state driver education courses.
The longer wait times for patients needing organs is contributing to the increase in organ donations from the living. Living donations jumped 16% last year, the largest increase on record. Living donations now account for nearly half of all donors, and at the current rate, living donors will outnumber cadaveric donors within a year or two, according to projections from UNOS.
"When you have to tell patients the wait is going to be three or four years, you say, I’d look around and see who might donate a kidney," says Adams.