Wide Variation in Transplant Liver Acceptance Rates Found

Wide Variation in Transplant Liver Acceptance Rates Found

Atlantic Article Focuses on David Goldberg Study

A University of Pennsylvania study led by David Goldberg that found wide variation in transplant centers' acceptance rates for harvested livers is the subject of a major article in The Atlantic magazine.

The headline of the piece is "When Donated Organs Go To Waste."


David Goldberg, MD, MSCE, Assistant Professor of Medicine and LDI Senior Fellow.

Goldberg, MD, MSCE, an Assistant Professor of Medicine at Penn's Perelman School of Medicine and LDI Senior Fellow, led a team that included LDI Senior Fellows Benjamin French, James Lewis, and Scott Halpern. They analyzed 23,740 donated organ offers and found that only 37% were accepted for the first-ranked patient.

Increased mortality
The study, published in the Journal of Hepatology, noted that organ acceptance rates at various centers ranged from 15.7% to 58.1%. They also found there was "a 27% increased odds of waitlist mortality for every 5% absolute decrease in a center’s adjusted organ offer acceptance rate."

Goldberg told an Atlantic interviewer that he was surprised by "the magnitude of the variability among centers, especially among centers in the same little geographic area."

10% of livers unused
The magazine reported that "In some cases, a rejection ultimately led to the organ not going to anyone at all -- in 2014, about 10% of livers that were recovered for transplants went unused." This, despite a severe national shortage of donated organs. It's estimated that 1,500 people die annually while on the waitlist for a donated liver.

One factor the magazine suggested might be at work behind high rates of rejection is "a center's reluctance to perform riskier surgeries for fear it could damage their statistics."

More transparency needed
"Patients, providers, and insurers," Goldberg told Atlantic, "really don't know anything about this stuff. This is an area that needs to have some more transparency."