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The Department of Health and Human Services and the United Network for Organ Sharing (UNOS) announced today that the number of organ donors increased 5.6 percent in 1998, the first substantial increase since 1995.

The increase follows the launch of the Clinton administration's donation initiative in 1997, as well as new regulations implemented last year which require hospitals to report all deaths to organ procurement organizations (OPOs).

Preliminary data show that the number of cadaveric donors rose to 5,788 in 1998, up from 5,479 in 1997. The increase resulted in approximately 600 additional organ transplants and up to 14,000 more tissue transplants.

"More Americans are hearing about the need for organ donation, and more are responding with the gift of life," said HHS Secretary Donna E. Shalala. "But we need to accelerate this trend. Organ donation saves lives, but the need for organs is still far greater than the supply. Too many patients still die while waiting for a transplant."

The increase in donors came during the first year following the launch of the Clinton administration's National Organ and Tissue Donation Initiative. Announced by Vice President Gore in December 1997, the National Initiative brings together dozens of partner groups, along with the nation's OPOs and the Coalition on Donation, a national non-profit organization promoting organ and tissue donation. The campaign emphasizes the need to inform family and others about one's decision to be a donor.

"We're letting people know that signing a donor card is not really enough. You have to tell your family," Secretary Shalala said. "It's families and loved ones who are usually asked to consent to donation, and their decision often is made under the most difficult circumstances. That decision is made much easier if the individual has told them in advance that he or she would want their organs to be offered for transplantation."

The Health Care Financing Administration (HCFA), the HHS agency that administers Medicare, is a key player in the campaign. HCFA last year began requiring all hospitals that participate in Medicare to inform routinely their local OPOs of all hospital deaths and imminent deaths. The

OPOs can then request donation from the families of potential donors. Previously, many families were never asked, and an estimated 3,000 to 4,000 potential donors annually were not identified. HHS estimates that this alerting requirement along with other donation activities can increase organ donation by 20 percent in the next two years.

HCFA also is requiring hospitals to have recovery partnership agreements with a tissue bank and an eye bank. A representative of an OPO, tissue bank, eye bank, or an individual trained in this area will discreetly discuss donation options with affected families. "We find that a sensitive, humane approach is not only respectful of the family's feelings, it also increases the likelihood that they will consent to donation. We hope that this new requirement will result in many more lives saved by caring families," said Nancy-Ann DeParle, HCFA administrator.

Other significant efforts to promote donation include a national public service campaign sponsored by the Coalition on Donation in collaboration with The Advertising Council Inc. since 1993; efforts by 62 local OPOs nationwide to address donation at the community level; and projects conducted by national groups, including the National Kidney Foundation and UNOS, to educate health professionals on donation and transplantation.

Donation increases between 1997 and 1998 were substantial for Caucasians (up 6.6 percent from 4,139 to 4,410 donors) and Hispanics (up 7.8 percent from 552 to 595 donors). The number of African-American donors remained relatively unchanged at 654 donors in 1998, and the number of Asian donors decreased by 8.4 percent from 107 to 98 donors.

Donors increased for all age ranges, but the largest increase was in donors age 60 and above (up 10.8 percent from 706 to 782). Donors age 40 to 59 increased by 9.6 percent (1,781 to 1,952). Donors age 20 to 39 increased by 2.4 percent (1,653 to 1,693) and age 0 to 19 increased only slightly by 1.6 percent (1,339 to 1,361).

"An increase in donations gives us added incentive to find out what works and replicate it across the country," said Claude Earl Fox, M.D., M.P.H., administrator of the Health Resources and Services Administration, the HHS agency with national responsibility for overseeing the organ donation and transplantation system. "Our plan is to fund creative, collaborative programs with rigorous evaluations so we'll know where to focus future efforts."

Waiting list registrations also climbed from 56,716 at the end of 1997 to 64,423 at the end of 1998, and the gap between supply and demand for organs continued to widen. "To the person anxiously awaiting a renewed chance at life through transplantation, there is no greater gift than a donated organ," said UNOS President William W. Pfaff, M.D. "However, tens of thousands still await this opportunity, and we must continue to foster the selfless act of donation to meet their need."

This year, April 18-24 is set aside to celebrate National Organ and Tissue Donor Awareness Week (NOTDAW). HHS will begin the week with a National Donor Recognition Ceremony and Workshop in Washington, D.C., on April 17 and 18 where donors and donor families will be recognized for their gifts that have allowed others to continue healthy, productive lives. Local OPOs plan special events in all parts of the country to highlight NOTDAW and bring attention to the need to make the choice to donate and tell one's family.

"Public education efforts have increased at all levels over the last four or five years, and we are beginning to see the effect of these efforts," said Howard Nathan, executive director of Philadelphia-based Delaware Valley Transplant Program and president of the Coalition on Donation. "With the implementation of the new federal rules for hospitals in the United States and continued public education, we anticipate that donors will continue to increase as more families are offered the option and say 'yes' to donation."

The largest increase in donations occurred in the central region of the United States. UNOS Region 10 (Michigan, Indiana and Ohio) had the largest increase at 13 percent (from 500 to 565). UNOS Region 8 (Iowa, Missouri, Nebraska, Kansas, Wyoming and Colorado) increased by 11.3 percent (from 380 to 423), and Region 4 (Oklahoma and Texas) increased by 9.1 percent (from 472 to 515).

The preliminary 1998 data were produced by UNOS from the Organ Procurement and Transplantation Network and Scientific Registry of Transplant Recipients statistics under its contract with HHS= Health Resources and Services Administration.

### Note: HHS press releases are available on the World Wide Web at: www.hhs.gov. UNOS information is available on the World Wide Web at: www.unos.org. More information about the National Organ and Tissue Donation Initiative is at www.organdonor.gov and the Coalition on Donation at www.shareyourlife.org.

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