Most Searched
Originally published May 22, 2025
Last updated May 22, 2025
Reading Time: 7 minutes
Search more articles
News & Magazine
Topics
In the United States, a shortage of organ donations leaves many patients without the hope of a life-saving transplant. It’s a deficit that transplant surgeons like Aaron J. Ahearn, MD, PhD, of the USC Transplant Institute, part of Keck Medicine of USC, are continually working to address.
Ahearn, who specializes in liver, kidney and pancreas transplantation and who is surgical director of the USC Liver Transplant and Comprehensive Liver Disease Center, discusses ongoing efforts to increase the number of organ donors. He also discusses reasons that keep more people in ethnic minority communities from becoming organ donors.
“We have a massive organ shortage in the U.S. Every year, for instance, 3,000 people in the U.S. die waiting on the transplant list for a liver. Organ scarcity is a concern throughout the United States and especially in some states.
For example, in California, liver and kidney recipients tend to wait longer than average to reach the top of the transplant list. There are a few reasons for this. First, the number of available organ donors in California is lower compared to the rest of the nation. This is because obesity rates are lower in California; therefore, people are less likely to die of diseases like heart attacks and strokes, which are conditions that are more likely to cause brain death and qualify someone to become an organ donor.
Not only that, but people on the West Coast in general have higher rates of liver disease. This means that on the West Coast, demand for liver donations tends to outstrip supply, and wait times are longer as a result.”
“Certain patient populations have a higher prevalence of diseases that translates into more demand for a specific kind of organ transplant.
For instance, Black patients are more prone to developing hypertensive renal disease and are more likely to undergo renal failure and need a kidney transplant. Hispanic patients, meanwhile, have higher rates of fatty liver disease and see more need for liver transplants. Asian and African populations have higher rates of endemic hepatitis B, develop more liver disease and have a greater need for liver transplants.
The list goes on. In pretty much every ethnic group, patients are more prone to certain diseases compared to the general population and this will impact their organ transplant needs.”
“It is usually easier to match organs between donors and recipients of a similar race and cultural background. Genetic factors like blood type and human leukocyte antigen (HLA) play a role in our ability to match donors and recipients.”
“Willingness to become an organ donor varies among cultural groups. When it comes to deceased organ donation, some have cultural concerns about how bodies are treated after death. Some also have less trust that medical systems are going to put organ donations to good use. Both concerns can usually be overcome through open discussion.
A lot of times people assume they can’t participate in organ donation because of conflicting religious or cultural beliefs. For transplant teams, it is important that these issues are brought out into the open and that as much information is provided as possible.
As transplant surgeons, our number one goal is to respect the wishes of a donor’s family. They are making this life-saving sacrifice, and we want to make sure that we support them in how they want their loved one to be treated after death.”
“We do see a lack of living donors overall in certain ethnic groups. Part of that is due to the cultural or trust issues mentioned above. However, the biggest barrier to becoming a living donor is usually socioeconomic.
In addition to sacrificing a part of their body to give this amazing gift, living organ donors need to take time off work for surgery and recovery. For this reason, people with greater financial resources are more likely to be able to become living organ donors.”
“A lot of it starts with education. At Keck Medicine, our transplant teams try to ensure that patients understand the advantages that a living-donor organ transplant provides and why it may be better than waiting for an organ to become available from a deceased donor. We try to get the word out to as many people as possible.
This is especially necessary when it comes to liver transplants. While kidney donation is a universally accepted concept across the United States, awareness around living-donor liver transplants is much lower. We want liver transplant patients to know that living organ donation is an option that exists and might benefit them.
We also spread awareness about how the National Living Donor Assistance Center (NLDAC ) can provide financial support to living donors. While a living donor’s medical costs are covered by the recipient’s insurance, incidental expenditures like lost wages, the cost of travel or the cost to stay in the area for treatment and recovery may not be covered. The NLDAC helps lower-income people bridge that gap.
In addition, the American Society of Transplant Surgeons is sponsoring a bill in Congress called the Living Donor Protection Act that would require Family and Medical Leave Act (FMLA) protection for organ donors so that they don’t have to worry about losing their jobs if they take time off work to donate an organ. I’m a strong advocate of this bill. It will eliminate some of the barriers encountered by people who are otherwise willing to donate an organ to a family member.
Finally, we assist people who want to become living donors but who are currently prohibited from doing so because of existing medical concerns. At Keck Medicine, our Donate Well Program helps living donors tackle health challenges like obesity or high blood pressure so that they can become organ donors. As mentioned, some patient populations have a higher prevalence of conditions like fatty liver disease, which means a patient’s family members and potential organ donors are more likely to be experiencing obesity or high blood pressure. We help family members improve their own health so they can donate an organ to their loved one.
Any person willing to consider donation should, and if they have any concerns, remember that your wishes are important and that we’ll do everything in our power to address them so that you can donate in a way that feels right.”
“Organs aren’t allocated based on ethnicity or geographic region. Organs are allocated based on medical urgency, meaning how likely it is that a patient will die without getting a transplant. The sickest patients get transplanted first. Organs are only allocated based on medical need and on making a good match between a donor and a recipient.
That said, genetic similarities can ensure a better match between a donor and a recipient because people from similar backgrounds are more likely to have similar immunological profiles. Some patients, in fact, are only able to accept organs from a donor who is genetically similar.
The bottom line, however, is that everyone has equal access to transplantation. And if you donate, you can count on the fact that your organ is going to get utilized by the person who needs it the most, no matter what your race or ethnic background is.”
“We’ve learned that we can safely transplant kidneys or livers that used to be considered non-transplantable. At Keck Medicine, this has enabled us to maximize the number of organs we can transplant. After all, the biggest risk for a liver transplant patient is dying while on the waitlist to get an organ. If we have an organ we can utilize — even if it’s not a perfect organ — it’s better to use it because the risks of doing so are lower than risks of the patient continuing to wait on the transplant list.
Finally, we want to make sure our education outreach to organ donors focuses on diversity. We want all groups to participate equally in organ donation to maximize the number of people who can receive these life-saving gifts.”
Share
