Where Do Organ Donors Come From in the United States? An Analysis of Urban and Rural Donation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-07-10 DOI:10.1111/ctr.70231

Anthony Shadid, Carolyn Chen, Elizabeth L. Godfrey, Addison Xu, John Goss, Abbas Rana

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Abstract

Background

One of the primary limiting factors in organ transplantation is limited supply of deceased donor allografts. Although there are multiple potential strategies to increase transplantation access, increasing donor organ supply remains a priority. This study aims to analyze the origins of donor supply based on donor and hospital ZIP codes.

Methods

Organ Procurement and Transplantation Network (OPTN) deceased donor database was analyzed. ZIP codes were assigned Rural-Urban Commuting Area (RUCA) code based on definitions from the WWAMI Rural Health Research Center. These RUCA codes, ranging from 1 (metropolitan core) to 10 (rural), allowed for a census-based classification of donor residential ZIP codes. Donor density was calculated as donors per million population. Proportionality between donor rurality was compared to general mortality data from the CDC WONDER database. Statistical analysis was performed in Stata 17.0.

Results

Rural zones and micropolitan zones supply 7.2% and 9.7% of donors despite accounting for 8.5% and 10.7% of deaths, respectively. In contrast, urban zones yield 83.1% of donors while accounting for 80.8% of deaths. Donors from rural and micropolitan regions were on average younger and more likely to have trauma-related mechanisms of death, while being less likely to be expanded criteria donors (ECD) or to have required pressor support. Lastly, rural and micropolitan donors were more likely to have written intent to donate.

Conclusion

The donor supply from rural and micropolitan regions is not fully reflective of their population size or donor potential. These communities may represent a valuable opportunity to expand the national donor pool through continued outreach and collaboration.

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美国的器官捐献者来自哪里？城乡捐赠分析

背景器官移植的主要限制因素之一是供体供体供体供体供体有限。虽然有多种潜在的策略来增加移植机会，但增加供体器官供应仍然是一个优先事项。本研究旨在分析基于供体和医院邮政编码的供体供应来源。方法对器官获取与移植网络（OPTN）的死亡供体数据库进行分析。根据WWAMI农村卫生研究中心的定义，分配了农村-城市通勤区（RUCA）编码。这些RUCA编码范围从1（大都市核心）到10（农村），允许基于人口普查的捐助者居住邮政编码分类。供体密度按每百万人口供体数计算。将供体农村比例与CDC WONDER数据库中的一般死亡率数据进行比较。在Stata 17.0中进行统计分析。结果农村地区和小城市地区的献血者分别占总死亡人数的8.5%和10.7%，但献血者的比例分别为7.2%和9.7%。相比之下，城市地区提供了83.1%的献血者，却占死亡人数的80.8%。来自农村和小城市地区的献血者平均更年轻，更有可能患有与创伤有关的死亡机制，而扩大标准献血者（ECD）或需要加压器支持的可能性较小。最后，农村和小城市的捐赠者更有可能有书面的捐赠意向。结论农村和小城市地区供体数量不能完全反映其人口规模和供体潜力。这些社区可能是通过持续的外联和合作扩大国家捐助者库的宝贵机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.