National Analysis of Recent Trends in Organ Donation and Transplantation in the United States: Toward Optimizing Care Delivery and Patient Outcomes

Abstract

Introduction In 2021, over 100 000 people were awaiting solid organ transplantation, yet only 44 634 transplants were performed. The aim of this study is to evaluate trends in donor availability, waitlist additions, and transplants performed in the United States from 2001 to 2021. Methods This was a retrospective analysis to evaluate trends in donor availability, waitlist additions, and solid organ transplants for the 4 most common organs requiring transplants (kidney, liver, heart, and lung) between 2001 and 2021 according to OPTN data. Results Between 2001 and 2021, the overall number of transplants performed, donors available, and waitlist additions increased by 71%, 61%, and 54%, respectively. The number of kidney transplant waitlist additions significantly increased compared to other organs ( P < .001). For each kidney transplant performed, there was a 2.25 increase in waitlist additions throughout the study period ( P < .001). For each liver and heart transplant performed, there was a .92 and .80 increase in waitlist additions, respectively ( P < .001). Lung transplants increased the most by 138% and there was an increase in waitlist additions for every transplant by 1.0 ( P < .001). Conclusion There was an absolute increase in the annual number of transplants, donor recruitment, and patients added to the waitlist between 2001 and 2021. Kidney transplant waitlist additions are increasing at a rate outpacing the rates of donor recruitment and transplantation.

The impact of macro‐ and micro‐steatosis on the outcomes of patients who undergo liver transplant: Analysis of the UNOS‐STAR database

“…This may further suggest that management of complications and co‐morbidities play a crucial role in post‐LT prognosis. Careful identification and management of vulnerabilities and patient co‐morbidities may therefore allow for expansion of the pool of viable donor livers to meet the increasing demand for organs 20 . Han et al.…”

“…The need for hepatic grafts is growing and the proportion of the population impacted by hepatic steatosis is expanding; it is important to consider the use of steatotic hepatic grafts in the setting of limited optimal donor organs, especially given the high risk of mortality from end‐stage hepatic dysfunction 20,27 . This study importantly identifies prognostic and mortality factors that pose a risk to LT recipients of steatotic grafts.…”

Dialyzing Brain-Dead for Organ Procurement

“…Organ transplantation has been increasing worldwide, although the availability of organs for transplantation remains limited [ 1 , 2 ]. Over the past few decades, the number of patients added to the organ donor waitlist has increased substantially, with reports as high as 154% between 2001 and 2021 [ 3 ]. Some also estimate that for every 10 minutes that pass, one patient is added to the transplant list, and 20 patients die per day waiting for a transplant [ 4 ].…”

Administrative coding of frailty: Its association with clinical outcomes and resource use in kidney transplantation

“…In part due to the continued rise in the prevalence of end-stage renal disease, additions to the kidney transplant waitlist continue to outpace rates of transplantation. 1,2 Thus, clinical care paradigms have persistently evolved to tackle the growing waitlist times and opportunity for improved performance of existing risk prediction models. 8,9 While traditional factors such as chronologic age and comorbidities have been used to estimate operative risk, more recent work suggested frailty to be a better predictor of postoperative outcomes.…”

“…In part due to the continued rise in the prevalence of end‐stage renal disease, additions to the kidney transplant waitlist continue to outpace rates of transplantation 1,2 . Thus, clinical care paradigms have persistently evolved to tackle the growing waitlist times and aging pool of transplant candidates 3–6 .…”