Wealthy patients may have an advantage over those most in need when it comes to receiving organ transplants in the United States, a new study contends.
That’s because registering at multiple transplant centers — which is more likely to be done by wealthy people with private insurance — can improve the chances of getting a new organ, the researchers said.
They reviewed data from the United Network for Organ Sharing collected between 2000 and 2013, and found that patients who simultaneously signed up at more than one transplant center had higher transplant rates and lower death rates while waiting. People who simultaneously signed up at more than one center tended to be wealthier and were more likely to be insured, the study revealed.
Two percent of the nearly 34,000 people waiting for a heart transplant were listed at multiple centers, as were more than 3 percent of the more than 24,600 waiting for a lung transplant. Just over 100,000 people were waiting for a new liver, and 6 percent them were listed at multiple centers. Of the more than 223,600 people waiting for a new kidney, 12 percent were registered at multiple centers, the study found.
The study was to be presented Monday at the American Heart Association’s annual meeting in Orlando, Fla.
Multiple listing is “an effective approach to address long waiting times and the shortage of organs available for the increasing demand among transplant candidates. But, it undermines a bedrock principle of organ transplantation — which is that the sickest people should be transplanted first,” study author Dr. Raymond Givens, an advanced heart failure and transplant fellow at Columbia University Medical Center in New York City, said in a heart association news release.
These findings show that wealthier patients have an advantage because they can afford travel, temporary housing and other costs of multiple listing that are not covered by health insurance. Patients covered with state-run Medicaid typically have low incomes and may not be able to sign up at transplant centers in other states, the researchers explained.
“We firmly believe the multiple listing policy needs to be reconsidered,” Givens said.
“The main issue is supply and demand. The need for donor organs increases yearly; the supply does not. We really need more people to volunteer to donate their organs. That would relieve a lot of the strain on these inequalities. From a policy perspective, there is a need to redesign the system of organ allocation to ensure fairer access,” he added.
Study findings presented at meetings are generally viewed as preliminary until published in a peer-reviewed journal.
The United Network for Organ Sharing has more about organ transplantation.