Study: Transplant Waiting Times Vary Widely Within Countries

The United States and other countries "show consistent and widespread regional differences" in the length of time that patients wait for organ transplants, according to a special report in the journal Transplantation.

The report on "Geographic Disparities in Access to Organ Transplantation" documented regional differences in access to organ transplants in France, the United States, the United Kingdom, Spain, and Australia.

In France, only 43 percent of patients placed on the waiting list in Paris ultimately get a transplant, compared to 63 percent of those on the waiting list in the western part of the country. As a result of these differences, only 2 percent of patients die while waiting for a transplant in western France, compared to 7 percent in the Southeast.

A U.S. study found that for kidney patients placed on the waiting list, transplant candidates, the number who had received a transplant within four months ranged from a low of 5.6 percent in New England to a high of 19.8 percent in the Southeast.

The situation was similar for patients with liver failure, with 11.8 percent receiving a transplant within four months in New England compared to 36.5 percent in the Southeast.

The best region for U.S. heart patients was the Northwest, where 55.8 percent received a transplant within four months compared to 39.6 percent in a region extending from Pennsylvania to West Virginia.

There were also discrepancies in heart transplants: 4-month rates were 43.9 percent overall, from a low of 39.6 percent (for a Northeastern region extending from Pennsylvania to West Virginia) to a high of 55.8 percent (for the Northwestern states, Alaska, and Hawaii). For liver transplants, the nationwide average was 22 percent, ranging from 11.8 percent (New England) to 36.5 percent (the Southeast).

Even in Spain, where the national government plays a major role in facilitating transplants, the researchers found significant differences from region to region, with shorter waiting times for patients awaiting liver transplants in the Valencia area.

"Equitable access to organ transplantation should be considered a national responsibility to the public at large," the researchers taking part in the study concluded.

They recommended that boundary adjustments, new prioritization schemes, and other approaches be studied to level out these geographic disparities to the greatest extent possible.

Other Sources: Transplantation