It is illegal in the United States to buy a human organ. But if you need a transplant, having money still gives you a better chance at getting an organ. A study has found that wealthy people are more likely to get on multiple waiting lists and obtain a transplant, and are less likely to die while waiting for one, a new study finds.
The study confirms the long-held idea that the rich have advantages even in a system that was designed to give priority to the sickest patients and those who have waited longest. The key difference is getting on to more than one transplant waiting list.
More than 122,000 Americans are waiting an organ, with the bulk of them-100,000-needing kidneys. As of August, only about 20,000 transplants have been done this year, according to the United Network for Organ Sharing (UNOS), the agency that runs the nation's transplant system. UNOS assigns organs based on a formula that considers how urgently a person needs the organ, their tissue type, the distance from the donor, the time they have spent on the waiting list, and other factors.
Dr. Raymond Givens at Columbia University Medical Center in New York and his colleagues studied UNOS records from 2000 to 2013 and found that patients on multiple transplant lists had higher transplant rates, lower death rates while waiting, were wealthier, and were more likely to have private insurance. About 2% of those seeking a heart, 6% of those seeking a liver, and 12% of those seeking a kidney are on multiple lists, the study found. Median incomes were higher in zip codes where people on multiple lists lived: $93,081 compared to $67,690 for people on just one list.
Death rates while waiting for an organ were higher among those on a single list versus multiple ones: 12% versus 8% for those seeking a heart; 17% versus 12% for a liver, and 19% versus 11% for a kidney.
To get onto additional transplant lists, a patient must often pay for a new set of tests, which can cost many thousands of dollars. They also need to be able to travel on short notice if an organ becomes available.