From CNN News

Study finds race and
gender gaps in organ
distribution

October 7, 1998
Web posted at: 9:49 a.m. EST (1449
GMT)

From Medical
Correspondent Dr. Steve
Salvatore

(CNN) -- Transplant
patients are living longer
than ever before, but a new
report finds that organs may not be distributed
proportionately according to race and sex.

A look in the 1997 report, published in this week's
Journal of the American Medical Association, shows graft
survival and patient survival rates are up. The conditional
three-year survival rate was up 90 percent for all organ
transplants except lung and heart/lung.

But not everyone is reaping the benefits. In a second study
of 7,125 kidney-dialysis patients in three states,
researchers found women, the poor and minorities were
much less likely to complete the steps of examination
needed to get on a waiting list for a donated kidney.

Blacks were 32 percent to 50 percent less likely to
complete the steps than whites. Women were 12 percent
less likely to complete the steps than men. Poor patients
were 22 percent to 33 percent less likely than the rich to
complete the steps.

The study did not look at why the steps were not pursued.

"The current organ allocation system is unfair to the
patients," said Secretary of Health and Human Services
Donna Shalala. "You can wait literally 500 days in one
part of the country, and walk off a golf course and get a
liver in another part of the country."

But who gets an organ ultimately depends on organ-donor
compatibility.

"There is a need if someone is to have the best graft
survival for biologic matching of the donor with the
recipient," said Dr. Edgar Milford of Brigham and
Woman's Hospital. "And that biologic matching
unfortunately, is less likely to occur when the donor is
Caucasian and the recipient is black."

Dr. Ashwini Sehgal, co-author of the study, says the
difference in organ distribution could be due to a variety
of factors including lack of a standard ranking system of
transplant patients, patients who do not want a transplant,
or patients who are medically unsuitable for a transplant.

There are efforts under way to improve the allocation of
organs.

Shalala says those who are sickest should get transplants
first and where someone lives should not hurt his or her
chances of getting a transplant.

"We need organs to follow need patients, not the organs to
stay in one place and expect the patients to come to them,"
she said.

United Network for Organ Sharing (UNOS), which is in
charge of organ sharing in the United States, opposes a
national system and fears if organs are given to the sickest
first, many will not survive -- resulting in organs being
wasted.

The Department of Health and Human Services disagrees
and insists it's only trying to set better, national standards
-- and wants transplant experts to work out the details.

The Associated Press contributed to this report.

Back to Medical News Page