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June 4, 2008

Economic Barriers in Organ Transplantation

JAMA. 2008;299(21):2512. doi:10.1001/jama.299.21.2512-a

To the Editor: The JAMA Patient Page on organ donation by Ms Stevens and colleagues1 states “[r]ecipients of organs are chosen by severity of illness, time spent on a waiting list, and medical factors, not by economic or celebrity status.” We believe that this statement is misleading.

Although it is true that economic status is not a factor in organ allocation once a potential recipient is on the waiting list, there are economic barriers to being placed on the waiting list.2 For patients of low socioeconomic status, including the uninsured, such barriers can occur at many steps3 and thereby lead to lower likelihood of receiving a transplant.