Need for Organ Transplantations Wait Times for Organ Donations Public Knowledge on Disparities Reactions After Donation References     Need for organ transplantation   Disparities in organ donation and receiving organ transplants among minorities have two sides.  Many minorities disproportionately suffer from illness that may require organ transplantation. Asian Americans have a slightly increased prevalence of End Stage Renal Disease (ERSD), which is increasing at a rate of 20% per year compared with annual increase of 8-9% in the general population.(1)There is a higher prevalence of end-stage renal disease, non-insulin dependent diabetes mellitus, hypertension, and higher chronic Hepatitis B carrier rates among Asians and Pacific Islanders than among whites and a higher prevalence of hypertension and diabetes among African Americans than among whites.  Asian Indians may also have an increased risk of ERSD. (1) (For more on this subject, go to Kidney Disease.) Thus, there is a disproportionately great need for organ donations among minority groups. Wait times for organ donations The other side of this problem is the disparity between the number of minority organ donors and the number of minorities on the organ waiting list.  The number of minorities on the organ transplant waiting list far exceeds the number of minority organ donors.  Non-Caucasians are not donating organs in proportion to their racial-group specific needs.(1) The number of patients per year on the kidney waiting list for Asians was ten times the number of donors, and there was a similar level of need among African Americans.  The number of patients per year on the liver transplant waiting list for Asians was more than five times the number of liver donors, a greater disparity than for African Americans and Hispanics. This has had an effect on the time a recipient must wait before receiving an organ.  In 1999-2000, wait times for kidneys for Asians (1780days), African Americans (1784days), Hispanics (1621days), Whites (1256days), American Indians (1494days), Pacific Islanders (2350days), and non-Hispanics (1921days).(2)  In the U.S., socioeconomic inequalities, including inadequate medical insurance, have long been considered factors in transplantation-related racial disparities.(1) Public knowledge Another factor that may lead to racial disparities in organ donation is lack of public awareness of the severity of the need.  Weaver et al. found that older Asians (age 40 yrs or older) did not believe that Asians wait twice as long as whites for kidneys. While younger Asians (age 18 yrs. or younger) did not believe that Asians make up only 1% of all organ donations. Information about disparities may be the key messages of a public education campaign for Asians in the U.S.(3) Feelings after donating organs.. A study by Shih et al. was conducted to find out the reaction of Asian families when deciding to donate the organs of their family members.  All family members in the study felt that the decision to donate organs was correct. (4) Forty-five percent of the subjects experienced some positive impact from their decision to donate organs, such as having a sense of reward for helping others as a result of the donation (36%), having closer family relationships (23%), having an increased appreciation for life (32%), and planning to shift life goals towards the study of medicine (9%).(4) Back to Top   References 1. Yoshida EM, Partovi N, Ross PL, Landsberg DN, Shapiro RJ, Chung SW. Racial differences between solid organ transplant donors and recipients in British Columbia: a five-year retrospective analysis. Transplantation 1999;67(10):1324-9. 2. Organ Procurement and Transplantation Network. Kidney Kaplan-Meier Median Wait Times for Registrations Listed 1997-2002. Based on OPTN Data as of July 29, 2005. http://www.optn.org/latestData/rptStrat.asp 3. Weaver M, Shiu-Thornton S, Spigner C, et al. Organ donation among Asians and Pacific Islanders: Preliminary Research Findings. J Health Poor Underserved 2002;14(2):182-193. 4. Shih FJ, Lai MK, Lin MH, et al. Impact of cadaveric organ donation on Taiwanese donor families during the first 6 months after donation. Psychosom Med 2001;63(1):69-78. This research was supported by a National Library of Medicine (NLM) Publication Grant #5G08 LM07653-02 in support of the creation of a web site titled Factline: Tracking Health in Underserved Communities, www.factline.org. Saqi S. Maleque, MSPH, Researcher, Principal Investigator: Virginia Brennan, PhD.