The United States liver donor population in the 1990s - A descriptive, population-based comparative study

Background Orthotopic liver transplantation in the United States is primari ly limited by a shortage of donor organs. Methods To better understand the low rates of organ donation in the United States and identify areas for potential improvement, we analyzed detailed d emographic and mortality-specific data from 10,689 adult cadaveric liver do nors obtained from the United Network for Organ Sharing from April 1, 1994 to March 31, 1997, Comparative U.S. population demographic and economic dat a were obtained from the U.S. census. Results. As compared with the U.S. population, we found there to be signifi cantly fewer nonwhite (P=0.001) and foreign-born donors (P=0.001); 58.9% of liver donors were male (P=0.001), The mean age was 40.6 years; yet during the 3-year period analyzed, there was a significant trend toward increasing age of donors. Median household income was 18% to 32% lower in the donor p opulation than in the general U.S. population. in 91.2% of cases, the donor cause of death was listed as cerebrovascular stroke or head trauma. Numero us significant interracial differences were found in both the donor mechani sm and circumstance of death. These included black donors being more likely to have gunshot wound as the listed mechanism of death (P=0.001) and to ha ve homicide as the listed circumstance of death (P=0.001). Conclusions. Nonwhites and foreign-born individuals are significantly under represented in the U.S. liver donor population, Furthermore, donors seem to be poorer than the general U.S. population. Increasing the liver donor poo l, especially among minorities, will require creative and thoughtful public initiatives.