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| April 22, 2002 | Contact: | HRSA Press Office (301) 443-3376 |
While medical advances now enable Americans to receive lifesaving transplants, not enough families or people donate to help everyone in need. About 6,000 people die in the U.S. each year -- about 16 every day -- while waiting for a donated kidney, liver, heart, or other organ. More than 79,000 Americans currently are waiting for organ transplants, and more than 30,000 people each year are diagnosed with diseases that a bone marrow transplant could cure.
In recent years, progress has been made in creating awareness of the need for organ and tissue donation. Although most Americans indicate they support donation, only about 50 percent of families asked to donate a loved one's organs agree to do so. Thousands of opportunities are missed each year because families do not know what their loved one wanted.
Background
The first U.S. organ transplant was performed in 1954 when surgeons removed a kidney from one identical twin and placed it in the other twin. With the use of tissue matching and improved surgical and organ preservation techniques, the number of kidney transplants reached 3,400 by 1980. By 1983, the immunosuppressant drug cyclosporine reduced the threat of organ rejection and made the successful transplantation of organs, especially hearts and livers, even more common.
The cyclosporine breakthrough helped create a demand for organs that greatly exceed the supply. Personal appeals for organs were commonly made by legislators or through the media, resulting in a disorganized and inequitable distribution of organs. It became clear that rules for organ recovery and ways to match the scarce supply of donated organs with critically ill patients needed to be developed.
Responding to the growing controversy, Congress passed the National Organ Transplant Act in 1984 to create a system to regulate the procurement, distribution and transplantation of scarce organs. The act established a national Organ Procurement and Transplantation Network (OPTN), which began work in 1986, and a Scientific Registry of Transplant Recipients (SRTR), a data-gathering and tracking service on transplant operations that was in place by late 1987. Both are funded by HHS - the OPTN is operated through a contract with the United Network for Organ Sharing in Richmond, Va., while the SRTR is operated through a contract with the University Renal Research and Education Association in Ann Arbor, Mich.
Organ Procurement and Transplantation Network
The OPTN's primary function is to maintain a national computerized list of patients waiting for organ transplants and to allocate organs when organs are donated. The network includes organ procurement organizations, transplant centers, tissue typing laboratories, hospitals and voluntary health organizations, as well as patients, patient families, donors and donor families. Its purpose is to ensure that all critically ill and medically qualified patients have equitable access to organs for transplantation and to guarantee that procured organs are used safely and efficiently.
As of April 2002, more than 79,000 patients were on the OPTN waiting list. Unfortunately, demand still heavily outweighs supply. In 2001, more than 6,000 people on the waiting list died, about half of them waiting for kidney transplants.
The SRTR receives data on all kidney, heart, lung, liver, pancreas, and intestine transplants performed since Oct. 1, 1987. Scientific and demographic data are gathered on organ recipients and reported annually. A total of 24,074 transplants were performed in 2001, a 4.7 percent increase over the 2000 total, and up from just 9,178 in 1985, the year following passage of the National Organ Transplant Act. Deceased donors totaled 6,081 in 2001, resulting in 21,920 organs recovered. This represents an increase of 1.6 percent in the number of deceased donors compared to 2000. Deceased organ donors increased by 6.4 percent among minorities. The number of living donors rose to 6,485 in 2001, an increase of 13.5 percent from 2000. The increase in living donation is largely from medical progress in the field of transplantation, the relative shortage of deceased donors, and efforts to increase organ donation.
Tissue Donation
When donor families give their consent, tissue is also taken for transplantation and made available through tissue and eye banks. Priority is given for emergency uses, especially skin for burn victims. Other tissue is used to benefit tens of thousands of patients in need of cornea transplantation as well as bone, cartilage and tendons for reconstructive surgery.
Marrow Donation
Up to 30,000 people per year are diagnosed with leukemia or other blood diseases for which a stem cell transplant may be a course of treatment. More than 20,000 of these patients will not find a matched donor within their family and must rely on strangers. The National Marrow Donor Program (NMDP), established in 1987, helps to match those patients with unrelated marrow donors.
Marrow is found inside bones, resembles blood, and contains stem cells. Stem cells produce red blood cells, white blood cells, platelets, and other blood components. For the donor, marrow constantly regenerates itself, replacing the extracted marrow completely within several weeks.
Current HHS Activities
HHS' Health Resources and Services Administration (HRSA) plays an instrumental role in funding and overseeing federal efforts to improve the national system of procuring, distributing and transplanting organs, tissue, bone marrow and blood stem cells. President Bush's fiscal year 2003 budget request includes nearly $25 million, an increase of $5 million, for HRSA's organ procurement and transplantation efforts. The requested level is targeted to increased efforts to encourage organ donation and education.
On his first day in office, Secretary Thompson expressed his clear intention to explore new ways to increase donation of organs, tissue, marrow and blood. In April 2001, Secretary Thompson launched a national campaign to encourage Americans to "Donate the Gift of Life." The campaign introduced the "Workplace Partnership for Life," an initiative in which unions, organizations and employers help to educate their personnel, members and volunteers about donation. More than 1,000 organizations joined the campaign in the first year.
Secretary Thompson also unveiled a model organ and tissue donor card that incorporates proven elements from existing donor cards. However, recognizing that just signing a donor card cannot ensure that a donor's wishes are carried out, the Secretary ordered a review of ways donors' wishes could be recorded electronically and made available to families and hospitals when needed.
Additionally, Secretary Thompson pledged to create a national medal and conduct national and regional ceremonies to honor donors and their families. In the coming year, HRSA will provide materials to states and schools designed to educate teenagers on donation prior to receiving a driver's license.
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