Strategies for Cadaveric Organ Procurement: Mandated Choice and Presumed Consent

THE SCARCITY OF ORGANS FOR TRANSPLANTATION The shortage of organs for transplantation is becoming more critical every year. Because of improvements in transplantation procedures, beginning with the advent of immunosuppressive therapies in the early 1980s, more patients now benefit from organ transplantation. As a result of transplantation's success, waiting lists for donor organs are increasingly crowded. Between December 1987 and June 1991, for example, the total number of patients on organ transplant waiting lists increased 75.3%, from 13153 to 23 056 patients. 1 For editorial comment see p 814. Tragically, the supply of donated organs has not kept up with this demand. Between 1987 and 1990, the number of organ donors per year stayed nearly constant, increasing from 4000 to 4357. 1 Even though each cadaveric organ donor can often supply multiple organs for transplantation, many patients still die before a suitable organ becomes available. In September 1991, the United