The United States liver donor population in the 1990s: a descriptive, population-based comparative study.
BACKGROUND
Orthotopic liver transplantation in the United States is primarily limited by a shortage of donor organs.


METHODS
To better understand the low rates of organ donation in the United States and identify areas for potential improvement, we analyzed detailed demographic and mortality-specific data from 10,689 adult cadaveric liver donors obtained from the United Network for Organ Sharing from April 1, 1994 to March 31, 1997. Comparative U.S. population demographic and economic data were obtained from the U.S. census.


RESULTS
As compared with the U.S. population, we found there to be significantly fewer nonwhite (P=0.001) and foreign-born donors (P=0.001); 58.9% of liver donors were male (P=0.001). The mean age was 40.6 years; yet during the 3-year period analyzed, there was a significant trend toward increasing age of donors. Median household income was 18% to 32% lower in the donor population than in the general U.S. population. In 91.2% of cases, the donor cause of death was listed as cerebrovascular stroke or head trauma. Numerous significant interracial differences were found in both the donor mechanism and circumstance of death. These included black donors being more likely to have gunshot wound as the listed mechanism of death (P=0.001) and to have homicide as the listed circumstance of death (P=0.001).


CONCLUSIONS
Nonwhites and foreign-born individuals are significantly underrepresented in the U.S. liver donor population. Furthermore, donors seem to be poorer than the general U.S. population. Increasing the liver donor pool, especially among minorities, will require creative and thoughtful public initiatives.
Gralnek
I M
IM
University of California Los Angeles (UCLA) School of Medicine, Division of Digestive Diseases, 90095, USA.
Liu
H
H
Shapiro
M F
MF
Martin
P
P
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002423:Cause of Death; D004641:Emigration and Immigration; D005006:Ethnicity; D005260:Female; D006801:Humans; D007182:Income; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D014019:Tissue Donors / Q000706:statistics & numerical data; D014481:United States