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Organ
Donation: A Crisis Among Minorities
by Jennifer Wider, M.D.
Society for Women’s Health Research
Newswise — The number of people needing
organ transplants is rising faster than the
number of donors, according to statistics
from the U.S. Department of Health and Human
Services.
Roughly 77 people receive organ transplants
per day in the United States, but 18 people
die each day waiting for transplants that
will never happen due to the shortage of
available organs.
Organ transplantation involves putting
organs or tissues from one person into the
body of another person, whose organs or
tissues have been damaged or are no longer
working.
“The recipient has to be immunologically
matched to the donor well enough that the
organ won't be immediately rejected,” says
Mark Schnitzler, Ph.D., assistant professor
of health administration at Washington
University School of Medicine in St. Louis.
“Blood type match has to be acceptable and
the recipient can’t be already sensitized to
the donor’s tissue types.”
The need for transplants is particularly
high among minorities, especially among
African-Americans. Of the 83,000 people on
the national transplant waiting list,
approximately fifty percent are minorities,
according to United Network for Organ
Sharing.
According to a recent study in the American
Journal for Respiratory Critical Care
Medicine, David J. Lederer, M.D., and
colleagues at Columbia University College of
Physicians and Surgeons in New York found
that, “After listing for lung
transplantation, African-American patients
with chronic obstructive pulmonary disease
were less likely to undergo transplantation
and more likely to die or be removed from
the list compared with Caucasian patients.”
Unequal access to care is among the likely
reasons Lederer and his team cited for this
disparity.
Organ donation recipients are more likely to
match up to others of their own race and
ethnicity. “Both blood type and tissue types
have racial and ethnic patterns,” Schnitzler
said. That is why it is important to look
into ways to increase minority organ
donations.
The need for more donor organs among
minority women is especially great because
minority women suffer disproportionately
from certain diseases of the kidney, heart,
lung, pancreas, and liver that can lead to
organ failure.
“Minority women are well represented as a
share of the total population that donates
organs, but their need for transplants is
greater,” said Sherry Marts, Ph.D., vice
president of scientific affairs for the
Society for Women’s Health Research, a
Washington, D.C., based advocacy
organization.
“Because of a shortage of appropriate donor
organs, minority women often have to wait
longer for doctors to find a match. Sadly,
many die waiting. With more donated organs
from minority women, finding a match will be
quicker, waiting times will be cut and more
lives will be saved.”
Further complicating matters are studies
that show the biological sex of the organ
donor and recipient can affect transplant
success.
At least one study has found that the
combinations least likely to result in organ
rejection are female recipient-male donor,
followed by male recipient-male donor.
“These findings have not yet affected
clinical practice because of the organ
shortage,” Marts said. “Doctors can’t afford
to wait for the most optimal donor-recipient
combination where the sex of the patients is
concerned.
"They
have to make the best decisions possible
with the limited organs available. As organ
preservation techniques improve, however,
this could become a factor.”
Health promotion and disease prevention
programs are needed to shed light on the
diseases and negative lifestyle choices that
may increase the need for organ transplants.
Diseases such as diabetes and hypertension
and behaviors including alcohol and
substance abuse, poor nutrition and lack of
exercise are all risk factors for diseases
that can cause permanent or irreversible
damage to organs and tissues.
The Minority Organ Tissue Transplant
Education Program is working to increase
awareness for minority organ donation. This
program also provides information that is
vital to good health and can delay or
prevent the need for organ transplants.
Here are some of the program’s key tips:
• Have your blood pressure checked at least
twice per year after age 12.
• Diabetics should have blood pressure
checked regularly and follow diet and
exercise instructions.
• Avoid alcoholic beverages to help prevent
liver disease.
• Avoid use of illegal drugs such as
marijuana, heroin and cocaine which cause
liver disease and kidney failure.
• Avoid smoking cigarettes which can lead to
heart and lung disease.
• Avoid foods high in cholesterol and
saturated fats such as fried foods which can
clog the arteries.
• Establish a regular exercise routine which
should be performed at least three times per
week.
• Visit your doctor at least once per year
for a check-up.
April is National Donate Life Month.
Information about organ and tissue donation
is available on a special Web site from the
U.S. Department of Health and Human
Services:
http://www.organdonor.gov.
STUDIES:
Lederer DJ, Benn EK, Barr RG, et al. Racial
differences in waiting list outcomes in
chronic obstructive pulmonary disease. Am J
Respir Crit Care Med. 2008 Feb
15;177(4):450-4. Epub 2007 Nov 15.
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