The global diffusion of organ transplantation: trends, drivers and policy implications (original) (raw)
Related papers
2019
who himself suffered from congenital kidney disease, addresses a challenge that confronts few people but in a deadly way. In the United States alone, more than 10,000 persons die annually because of a shortage of organs for transplantation (Ch. 1). Kidney transplantation in particular results not ony in a far better quality of life, but is also very cost-effective, at an estimated 16,000perquality−adjustedlifeyear,whichisfarbelowthe£30,000thresholdadoptedbytheUKNationalHealthService(Ch.4).Yetsome93,000U.S.kidneypatients(asof2012)waitforamedianof1,833days(asof2003)foratransplant.Othercountriesarenotmuchbetter.Forexample,inEurotransplant,comprisingAustria,Belgium,Germany,theNetherlands,Solvenia,andCroatia,themodalwaitingtimeisbetween2and4years;almost3016,000 per quality-adjusted life year, which is far below the £30,000 threshold adopted by the UK National Health Service (Ch. 4). Yet some 93,000 U.S. kidney patients (as of 2012) wait for a median of 1,833 days (as of 2003) for a transplant. Other countries are not much better. For example, in Eurotransplant, comprising Austria, Belgium, Germany, the Netherlands, Solvenia, and Croatia, the modal waiting time is between 2 and 4 years; almost 30 % of patients (as of 2009) have been on the waiting list for 5 years or longer. And in the case of Scandinaviatransplant, comprising Denmark, Finland, Norway, and Sweden, there were (as of 2009) 1,558 patients, while 89 had died waiting (Ch. 3). With incomes and health aspirations rising fast in the rest of the world, the global organ shortage will become ever more acute. The crucial insight of the authors is that this sad state of affairs is not the result of market failure, but rather of government failure. Current policy is largely inspired by the U.S. National Organ Transplant Act of 1984 that served as the model for an ''altruistic consensus'' supported by the World Health Organization (WHO) and in particular the World Medical Organization (WMO). This consensus views financial compensation for organs to be unethical and illegal. At the same time, Becker and Elias (2008) estimate the world equilibrium price of a kidney provided by a living donor at 16,000perquality−adjustedlifeyear,whichisfarbelowthe£30,000thresholdadoptedbytheUKNationalHealthService(Ch.4).Yetsome93,000U.S.kidneypatients(asof2012)waitforamedianof1,833days(asof2003)foratransplant.Othercountriesarenotmuchbetter.Forexample,inEurotransplant,comprisingAustria,Belgium,Germany,theNetherlands,Solvenia,andCroatia,themodalwaitingtimeisbetween2and4years;almost3015,000. For an economist, three predictions emerge: (1) At a zero price, not much supply is forthcoming; with demand increasing, there will be a growing global organ shortage, (2) There will be an (largely illegal) international trade in organs because the reservation price of donors is much lower in poorer countries than in rich ones, (3) Due to the disjoint between supply
Organ donation in the US and Europe: The supply vs demand imbalance
Organ donation in the US and Europe: The supply vs demand imbalance, 2020
a r t i c l e i n f o Available online xxxx Keywords: Organ donation Organ donor Organ transplant Donation after brain death Donation after circulatory death Organ shortage Organ donation and transplantation remain the best and most cost-effective clinical solution for end-stage organ failure. Several agencies across the US and Europe provide legislative, regulatory, and humanitarian services to generate smoother applications in all transplantation processes and donor-recipient relationships. US and European statistics present nine types of grafts, with kidneys being the most transplanted organ worldwide. However, organ shortage, religion, underrepresented minority groups, difficulties in obtaining consent, lack of understanding, and general ethical concerns present challenging barriers to organ donation, reflecting the complexity of graft procurement and allocation. Breaking down these barriers to reduce the organ-supply imbalance requires an appropriate multifaceted approach. Some of the key areas include increasing the potential donor pool and consent rates, apt organ allocation, and improving organ health. Additionally, suitable policies and standardized guidelines for both donors and recipients, alongside educational initiatives, are needed to ensure patient safety and global awareness. Looking forward, novel and effective research plans and initiatives are needed if we are to avoid a colossal supply-demand gap.
Law and Contemporary Problems
Since the beginning of human kidney transplantation six decades ago, and especially since the first heart transplant and the creation of deceased-donation programs forty-five years ago in the United States, the Western model for organ donation has been one of unpaid giving. Such a donation typically occurs for what are termed "altruistic" reasons, meaning that the organ donor is not acting for material gain. Proposals in the developed countries to overcome the shortage of human organs for transplantation by creating a market or providing other financial incentives or benefits to donors are unlikely to increase the net number of organs available, would spread to Western countries the exploitation of poor and vulnerable organ sellers that has occurred for decades in a number of developing countries, and would undermine the still tenuous progress made over the past decade in those countries, responding to the principled stand of intergovernmental and professional organization...
Living Organ Transplantation Policy Transition in Asia: towards Adaptive Policy Changes
Advances in medical science have opened up a new supply channel of organs for sick patients. But health policies to match supply to demand, in particular the use of financial incentives for organ procurement, have been stymied largely at the formulation stage. This paper maps these policies in ten Asian economies along two defining variables: donor restriction and donor compensation. It finds substantial adaptive changes over the past two decades -half of these cases show a substantive change in either expanding donor eligibility, legalizing compensation, or both. The resulting analysis illuminates the need for a regulated liberalization of related policies and the establishment of regional governance perspectives.
A Global Strategy to Increase Organ Donation at Hospital and Jurisdictional Levels
Transplantation, 2017
Copy editing, graphic design and DTP Guénette + Delisle design et communication English translation Anglocom Revision James Cookson et Karin Montin, s.e.n.c. DISTRIBUTION Association québécoise d'établissements de santé et de services sociaux et autres 505 De Maisonneuve Boulevard West, Suite 400 Montreal, Quebec H3A 3C2 Telephone: 514-842-4861 © Association québécoise d'établissements de santé et de services sociaux Legal deposit-Q1 2015 Bibliothèque et Archives nationales du Québec Library and Archives Canada ISBN 978-2-89636-206-6 (print) ISBN 978-2-89636-203-5 (PDF) This document is available from the following websites: www.acmdp.qc.ca www.aqesss.qc.ca www.hema-quebec.qc.ca www.transplantquebec.ca Excerpts may be reproduced for non-commercial use, provided that credit is given. Any partial reproduction must stay true to the original.
Organ donation and transplantation: a multi-stakeholder call to action
Nature Reviews Nephrology, 2021
Although overall donation and transplantation activity is higher in Europe than on other continents, differences between European countries in almost every aspect of transplantation activity (for example, in the number of transplantations, the number of people with a functioning graft, in rates of living versus deceased donation, and in the use of expanded criteria donors) suggest that there is ample room for improvement. Herein we review the policy and clinical measures that should be considered to increase access to transplantation and improve post-transplantation outcomes. This Roadmap, generated by a group of major European stakeholders collaborating within a Thematic Network, presents an outline of the challenges to increasing transplantation rates and proposes 12 key areas along with specific measures that should be considered to promote transplantation. This framework can be adopted by countries and institutions that are interested in advancing transplantation, both within and outside the European Union. Within this framework, a priority ranking of initiatives is suggested that could serve as the basis for a new European Union Action Plan on Organ Donation and Transplantation.
Progress in Organ Donation and Transplantation: A Critical Review of Literature
Global Journal of Health Science
The majority of countries are battling with a high incidence of organ failure such as the kidneys, heart, lungs, pancreas, and liver. The only solution that can remedy the plight of patients facing the strong likelihood of death as a result of malfunctioning body organs is organ donation and transplantation. The intention of this literature study is to assess progress in organ donation and transplantation. This study has benefitted immeasurably from previous scientific investigations. Four hundred and thirty-one published papers were selected from different accredited journals. The study found that many of the countries that have implemented the opt-in system are struggling to close the gap between the high demand for and the actual availability of life-saving organs due to low rates of registered and committed organ donors. The majority of patients that are contending with end-stage diseases are added to the organ donation waiting lists, but have little hope of receiving life-prolo...
A trend analysis of organ transplantation among ethnic groups
Journal of the National Medical Association, 2002
This research provides public policy implications regarding organ resource allocation and increases public awareness of the current status of transplant use in various ethnic populations. Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS) data were used to obtain a yearly estimate of the number of organ transplants by organ and by ethnic origin for 1988-1997. ICD-9-CM codes identified lung, heart, liver, and kidney organ-transplantation procedures. Each record in the sample was weighted by its respective discharge weight in order to extrapolate a national estimate. To assess whether there are significant differences among ethnic groups in organ transplantation rates over time, regression models were estimated for heart, liver, and kidney transplants. Transplantation rates were modeled as a function of time, ethnic origin, and interaction variables. Examination of time trend graphs and regression analyses indicates that transplantation rates have not vari...