McGowan Institute for Regenerative Medicine
affiliated faculty member Mark Roberts, MD, MPP (pictured), Chair of Health Policy and Management at the University of Pittsburgh’s Graduate School of Public Health, comments in a recent issue of The Journal of the American Medical Association in an editorial entitled “Improving the Supply of Donor Organs: Being Careful With the Gift of Life.” The editorial accompanies the articles “Estimated Supply of Organ Donors After Circulatory Determination of Death: A Population-Based Cohort Study” and “Effect of a Lung Protective Strategy for Organ Donors on Eligibility and Availability of Lungs for Transplantation: A Randomized Controlled Trial.” The articles announce the results of the studies authored by researchers in the United States and in Spain, Canada, and Italy, respectively.
In his editorial, Dr. Roberts notes donor organs are a valuable but scarce resource that provide a lifesaving procedure to thousands of patients per year. However, the demand for organs of all types far exceeds supply. In 2009, 50,463 patients were added to the United Network for Organ Sharing's wait list, 28,463 patients received an organ transplant, and 6683 patients died while waiting for a suitable organ. Despite substantial effort and research devoted to improving donation rates in the United States, these rates remain substantially lower than those in many other developed countries. Many techniques such as implied consent, opt-out policies, breakthrough collaborative and quality improvement methods, and financial incentives have been proposed to expand the pool of organ donors.
In the study conducted at 12 centers in Italy and Spain, researchers compared two different artificial breathing strategies in 118 patients whose organs were to be donated. Half were put on a ventilator using conventional settings, while the other half had “protective” settings that lowered air flow and decreased pressure on exhalation. In the first group of 59, the lungs of 16 donors could be used for transplantation; in the protective group, the lungs of 32 patients were healthy enough to be transplanted.
"They found remarkable increases in the availability of viable lungs using this lung preservation strategy," said Dr. Roberts.
Using the protocols at United States hospitals has the potential to virtually eliminate the lung shortage, Dr. Roberts said.
"If you can double the amount of lungs available for transplants that can almost wipe out the shortage between what is demanded and what is available," Dr. Roberts said. "It would make a huge difference."
Illustration: McGowan Institute for Regenerative Medicine.
The Globe and Mail (12/14/10)
Business Week (12/14/10)
Extract (The Journal of the American Medical Association, 2010;304(23):2643-2644.)
Extract (The Journal of the American Medical Association, 2010;304(23):2592-2594.)
Abstract (The Journal of the American Medical Association, 2010;304(23):2620-2627.)
Bio: Dr. Mark Roberts