Although medical and technological advancements have changed the face of organ donation and transplantation, the gap between supply and demand continues to grow, in part, due to government agencies’ high level of scrutiny toward transplant centers. A recent study published in the American Journal of Transplantation has revealed that even as heart transplant waiting lists continue to grow, the number of donor hearts available for transplantation in regions of the United States has remained stagnant.

"We, as a heart transplant community, are using a small fraction of available donor hearts for transplantation, and we have become more conservative over the past 15 to 20 years in terms of donor heart acceptance," Dr. Kiran Khush, from the Stanford University School of Medicine, said in a statement. "This finding is troubling in the setting of a national donor heart shortage and an ever-growing number of critically ill patients awaiting heart transplantation."

Khush and her colleagues used the Organ Procurement and Transplantation Network (OPTN) for all possible adult cardiac organ donors between 1995 and 2010 to analyze national trends in donor heart acceptance for transplantation. The research team accounted for donor age, gender, and medical conditions which generally predicted non-acceptance of hearts from donors. Heart failure diagnoses have increased dramatically in the U.S., and half of these patients die within five years of being diagnosed.

Over the course of 15 years, the rate of donor heart acceptance declined significantly from 44 percent in 1995 to 26 percent in 2006, but subsequently increased in 2010 to 32 percent. As donor age and medical conditions increased over time, acceptance of hearts from donors with undesirable characteristics decreased. After discovering that regions of the U.S. varied in terms of donor heart utilization, the research team called for standardized donor heart acceptance practices with clinical guidelines.

According to the OPTN, a new name is added to the national transplant waiting list every 10 minutes. Approximately 21 people die every day while waiting for a transplant. There are currently 123,204 people in need of a lifesaving organ transplant, 77,885 of which are active waiting list candidates. A total of 27,036 transplants were performed between January and November 2014 using 13,125 donors. A single organ donor can save up to eight lives.

Even if the rate of donor heart acceptance continues to decline, evidence has still shown that organ donations and transplantations save lives and improve a recipient’s quality of life. A study published in JAMA examined the medical records of more than 1.1 million patients, including 533,329 who received an organ transplant and 579,506 who were placed on a waiting list and did not receive a transplant. Organ donations saved 2,270,859 years of life, averaging out to 4.3 years of life for each transplant recipient.

Source: Goldstein B, Menza R, Nguyen J, Zaroff J, Khush K. National Decline in Donor Heart Utilization With Regional Variability: 1995–2010. American Journal of Transplantation. 2015.