Organ Donation

Improvements in immunosuppression, organ preservation, surgical technique, as well as long-term recipient management have led to tremendous success following transplantation. Consequently, more patients than ever before have benefited from transplantation. Unfortunately, the rate of organ donation has not kept pace with the ever-increasing recipient waiting lists. Recent United Network for Organ Sharing (UNOS) statistics reveal that greater than 80,000 patients (Table 5.1) currently await transplantation. For a variety of reasons, some organ procurement organizations (OPOs) have very high organ donation rates while others fall significantly below average. Likewise, consent for organ donation averages approximately 60%, although several OPOs have much higher consent rates. Clearly, much greater emphasis needs to be placed on increasing organ donation. Organizations such as the Coalition on Organ Donation, the American Society of Transplant Surgeons (ASTS), UNOS, and the American Association of Organ Procurement Organizations (AOPO) are leading the way in this effort. Still a critical shortage of organs exists which has resulted in an increase in the use of live donation and an increase in the use of expanded cadaveric donors. Since criteria for the use of organs has expanded significantly, any patient who is declared brain dead or who is being withdrawn from support should be considered as an organ donor.

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