Transplantation risks and the real world: what does 'high risk' really mean?

TitleTransplantation risks and the real world: what does 'high risk' really mean?
Publication TypeJournal Article
Year of Publication2009
AuthorsFreeman RB, Cohen JT
JournalAm J Transplant
Pagination23 - 30
Date PublishedJan
ISSN1600-6143 (Electronic) 1600-6135 (Linking)
Accession Number19067660
KeywordsAdolescent, Adult, Child, Decision Making, Disease Transmission, Infectious, Humans, Informed Consent, Middle Aged, Risk Assessment, Tissue Donors, Transplantation / *adverse effects / mortality, Waiting Lists

Candidates for, and recipients of, transplants face numerous risks that receive varying degrees of attention from the media and transplant professionals. Characterizations such as 'high risk donor' are not necessarily accurate or informative unless they are discussed in context with the other risks patients face before and after transplantation. Moreover, such labels do not provide accurate information for informed consent discussions or decision making. Recent cases of donor-transmitted diseases from donors labeled as being at 'high risk' have engendered concern, new policy proposals and attempts to employ additional testing of donors. The publicity and policy reactions to these cases do not necessarily better inform transplant candidates and recipients about these risks. Using comparative risk analysis, we compare the various risks associated with waiting on the list, accepting donors with various risk characteristics, posttransplant survival and everyday risks we all face in modern life to provide some quantitative perspective on what 'high risk' really means for transplant patients. In our analysis, donor-transmitted disease risks are orders of magnitude less than other transplantation risks and similar to many everyday occupational and recreational risks people readily and willingly accept. These comparisons can be helpful for informing patients and guiding future policy development.

Notify Library Reference ID544

Related Incidents