Organ donation: The big picture

Blood and organs are in constant need – each year, the United States faces a shortage of both. As the population increases in age, health ailments rise in frequency and the demand for organs and blood continues to escalate. The undersupply and strong demand makes industry services indispensable, and fortunately, medical advances are improving transplant applications. Even so, blood and organ banks depend on financial contributions because many are nonprofit organizations. This factor exposes the Blood and Organ Banks industry to fluctuations in the economy, since people and companies are less willing to donate during times of financial hardship. The recent economic recession caused revenue to fall in 2009. A reduction in insurance coverage and in elective procedures that use tissue donations also contributed to the decline. Fortunately, the industry is expected to turn around. In 2011, revenue is expected to grow 4.6% to $10.5 billion as the economy continues to recover, which will contribute to average annual growth of 3.9% during the five years to 2011. Growth will accelerate in the next five years, boosted by implementation of an insurance exchange as part of the 2010 healthcare reform bill. The population will continue to age, but at a slower rate, and technological advances in the healthcare sector will bolster industry demand. These factors will dependably foster industry growth. The instance of man-made or natural disasters could also cause revenue to rise because contributions surge as companies like the American Red Cross expand fundraising efforts and individuals become more willing to contribute. Although such natural disasters are unpredictable, revenue is forecast to increase 7.0% per year on average to $14.8 billion over the five years to 2016. While industry revenue is forecast to grow, escalating regulatory costs will encourage operators to consolidate to maintain profitability. During the five years to 2016, the number of organizations is forecast to decrease 3.6% per year on average to 245. This consolidation will help boost operating profit margins to 5.3%.

The Blood and Organ Banks industry is growing and will continue to grow at a pace that is faster than the rate of growth of the overall US economy. This is common for a healthcare industry – the US health sector as a whole generally grows faster than the US economy. During the 10 years to 2016, the value that the industry adds to the economy is forecast to increase 5.8% on average per year. This is considerably higher than the forecast for US GDP growth of 1.8% during the same period. The demand for whole blood and its constituents is increasing due to a rise in blood transfusions. This, in turn, is boosted by growth in organ transplants and other blood-intensive procedures. In recognition that early detection and prevention can reduce overall health costs, health screenings will be promoted by an increase in third-party reimbursement of screenings. An aging population will also bolster demand for many services in this industry. The US population of people aged 50 and older is forecast to grow significantly in the five years to 2016.

Organ Transplantation: A Closer Look

To address the nation’s critical organ donation shortage and improve the organ matching and placement process, the U.S. Congress passed the National Organ Transplant Act in 1984. The act established the Organ Procurement and Transplantation Network to maintain a national registry for organ matching. The act also called for the network to be operated by a private, non-profit organization under federal contract. Waiting time is the primary challenge for persons who are candidates for the transplant process. Waiting times vary widely for many reasons. The shortage of organs causes most patients to wait for a transplant. The amount of time a patient waits does not show how well a transplant center or OPO is doing its job. Each patient’s situation is different. Some patients are more ill than others when they are put on the transplant waiting list. Some patients get sick more quickly than other patients, or respond differently to treatments. Patients may have medical conditions that made it harder to find a good match for them. How long a patient waits depends on many factors including:

Options to Consider

As an informed participant, it is important that transplant candidates know their treatment options. Some patients choose to list at hospitals in different parts of the country, change hospitals, and transfer their waiting time to a different center or receive a transplant from a living donor.

  • Multiple Listing: Sometimes patients choose to register for a transplant at more than one hospital. When a patient lists at a transplant hospital, they are generally considered for organs from a donor in that local area first. If a patient is put on the list at more than one transplant hospital, they will be considered for donor organs that become available in more than one local area.
  • National transplant policy allows a patient to register for a transplant at more than one transplant hospital. However, each hospital may have its own rules for allowing its patients to be on the list at another hospital. Patients should ask each hospital whether it allows its patients to list at more than one transplant hospital. Being listed in more than one area does not guarantee an organ will become available faster than for patients registered at only one transplant hospital. Generally, each transplant center will require the patient to go through a separate evaluation, even if the patient is already listed at another hospital.
  • Transferring Waiting Time: In some cases, patients may switch to a different transplant hospital and transfer their waiting time to that hospital. Waiting time from the original center is added to the time collected at the new hospital. The transplant teams at the first hospital and the new hospital will be responsible for coordinating the exchange of information and notifying UNOS of the transfer of waiting time. Patients should ask each hospital if transferred waiting time would be accepted.
  • Variability among Transplant Centers: Hospitals can vary widely in the number of transplants they perform and the characteristics of the donor and recipient pool. Organ procurement organizations can vary widely in the number and types of donors they receive each year.
  • Living Donation: In addition to deceased organ donation, patients may also receive organs from living donors. In 2007, more than 6,300 living donor transplants were performed. With more than 100,000 people currently waiting for a transplant in the U.S., the need for donor organs is far greater than the supply. Living donation offers an alternative for individuals awaiting transplantation.