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Effects of Ethnicity on Deceased Organ Donation in a Minority-Majority State*

Moore, Sarah Annie MD1; Myers, Orrin PhD2; Comfort, David RRT, CPTC3; Lu, Stephen W. MD1; Tawil, Isaac MD, FCCM4; West, Sonlee D. MD2

doi: 10.1097/CCM.0000000000000215
Clinical Investigations
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Objective: To define how ethnicity affects donation rates in New Mexico when compared with the United States. We hypothesized that deceased donation rates in New Mexico would reflect the ethnic rates of the population.

Design: We performed a retrospective review of the Organ Procurement Database for New Mexico from 2009 to June 2012.

Methods: Rates for donors and transplant candidates were calculated relative to 2010 census population estimates by ethnicity for non-Hispanic Whites, Hispanics, and American Indians. Poisson regression analyses were used to test whether United States and New Mexico rates differed. Rates were scaled to 100,000 patient-years for reporting.

Setting: State of New Mexico population compared to United States population.

Subjects: Reported deaths to New Mexico Donor Services and United Network for Organ Sharing from 2009 to 2012.

Interventions: None.

Measurements and Main Results: Non-Hispanic White age-adjusted donor rates per 100,000 patient-years were 2.58 in New Mexico versus 2.60 in the United States, Hispanic donor rates were 1.98 in New Mexico versus 2.03 nationwide, and American Indian donor rates in New Mexico were 0.26 versus 1.23 nationwide (rate ratio = 0.21; 95% CI, 0.05–0.86). American Indians have significantly lower donor rates in New Mexico compared to non-Hispanic Whites (rate ratio = 0.11) and Hispanics (rate ratio = 0.13) and nationally (non-Hispanic Whites: rate ratio = 0.32 and Hispanics: rate ratio = 0.43). Hispanics and non-Hispanic Whites had similar donor rates regardless of geographic strata (Hispanics vs non-Hispanic Whites, New Mexico: 0.83; United States: 0.75). In New Mexico, Hispanic patients were 1.43 times more likely to be listed as transplant candidates than non-Hispanic Whites and American Indians were 3.32 times more likely to be listed than non-Hispanic Whites. In the United States, Hispanic patients were 1.90 times more likely to be listed as transplant candidates than non-Hispanic Whites and American Indians were 1.55 times more likely to be listed than non-Hispanic Whites.

Conclusions: Donor and transplant candidate rates did not show strong differences by geographic strata. These findings suggest that further work is needed to elucidate the causes for ethnic differences in rates of consent and donation, particularly in the American Indian population.

1Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM.

2Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM.

3New Mexico Donor Services, University of New Mexico School of Medicine, Albuquerque, NM.

4Department of Anesthesia and Critical Care Medicine, University of New Mexico School of Medicine, Albuquerque, NM.

* See also p. 1546.

Supported, in part, by the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) through grant number UL1TR000041. The content is the sole responsibility of the authors and does not necessarily represent the official view of the NIH.

Dr. Myers received support for article research from the National Institutes of Health (NIH). His institution received grant support from Clinical Translational Science Award/NIH. Dr. Tawil is the associate medical director for New Mexico Donor Services. Dr. West received support for article research from the NIH. Her institution received grant support from Biostatistics core of Clinical and Translational Science Center (provided support for statistical analysis of data). The remaining authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: sowest@salud.unm.edu

© 2014 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins