Are efforts at expanding the donor pool misdirected?

Area of Science:

• Cardiovascular Surgery
• Transplantation Medicine
• Organ Donation

Background:

• The demand for heart transplants significantly outweighs the supply of donor organs.
• There's growing interest in utilizing hearts from donors previously deemed unacceptable.
• Long-term outcomes for hearts from extended criteria donors are not well-established.

Purpose of the Study:

• To evaluate strategies for increasing the availability of donor hearts.
• To compare the potential impact of extended donor criteria versus improving consent rates.

Main Methods:

• Conducted literature reviews on extended donor criteria and consent processes.
• Analyzed United Network for Organ Sharing data on unrecovered consented heart referrals.
• Obtained data from the Association of Organ Procurement Organizations on US consent rates.
• Estimated potential additional hearts from both strategies.

Main Results:

• Over 40 articles proposed extended donor criteria, compared to 12 on consent.
• Over 1300 unrecovered consented heart referrals could potentially be used with extended donor strategies.
• Aggressive use of extended donor criteria could yield an estimated 701 additional hearts.
• Increasing the consent rate could yield an estimated 1260 additional high-quality hearts.

Conclusions:

• Research into extended donor criteria is warranted but may not be the most effective strategy.
• Focusing on improving the organ donor consent process offers a greater potential for increasing the supply of high-quality donor hearts.
• Transplantation programs should prioritize research and initiatives aimed at enhancing consent rates.