Donated organ shortage hinders transplant success

WASHINGTON (CNN) -- Once-experimental organ transplants have become a treatment of choice for people with organ failure, but a low consent rate among families of potential donors is preventing greater success, a new study says.

While 75 percent of people said they would be willing to donate their organs, fewer than 50 percent of potential donors actually did so, according to the study published in the July 4 issue of the Journal of the American Medical Association.

The study's authors stress the need to better educate the public about organ donation and for improvements among health care professionals in making donation requests.

Seventy-five thousand Americans are waiting for organs, but demand outweighs supply three to one.

RESOURCES Read the full study in the Journal of the American Medical Association

"The big problem is that the number of patients keeps going up 15 to 20 percent per year, and the number of donors only changes about 5 percent to 10 percent each year," said Dr. Jimmy Light, director of transplantation services at Washington Hospital Center.

When matching a donor and recipient, doctors must consider medical urgency, blood type, organ size, genetic makeup and time the recipient spent on a waiting list.

Use of older organs increases

One way to cut the waiting time is to accept an "extended criteria" organ -- one that is older, damaged or otherwise less than ideal.

"Today we might use a liver from a 70-year-old donor or a 75-year-old donor whereas five or 10 years ago we wouldn't have even considered it. With the heart you might use a 55- or 60-year-old person, whereas a heart donor five years ago you wouldn't have accepted someone over 40, 45," Light said.

Using extended criteria organs may increase the supply by 10 to 15 percent, according to the lobbying group, Patient Access to Transplantation Coalition. But is it ethical?

"There's obviously a huge worry that less than suitable organs are actually going to lead to patients having false hopes and ending up dying," said Dr. Ezekiel Emanuel of the Department of Clinical Bioethics at the National Institutes of Health.

Living donors

Instead of accepting second-rate organs, more families of potential recipients are becoming living organ donors. They donate a healthy kidney to the waiting list so one person comes off the list in exchange for their relative getting the next available organ.

Light predicts that within five years, living donors will account for maybe 20 percent of kidney donations.

"As a society, we're willing to entertain lots of issues and possibilities because of the large shortfall of organs. That's not a good circumstance, necessarily, to make rational and prudent decisions," Emanuel said.

George Wynn, who is 44, received organs from a 59-year-old donor. He's happy to have functioning kidneys -- even if they were considered marginal when they were transplanted.

"I think most dialysis people don't care. They want to get away from that machine. They want to get away from that pain," he said.

Like most transplant patients, Wynn knows the organ could fail or be rejected by his body. He'd go back on dialysis, back to the transplant waiting list.

"If another came about that was less than perfect, I'd take it," he said.

CNN Medical Correspondent Rea Blakey contributed to this report.