WS MoreOrLess: Liver Transplant.

Summary

More or Less: Liver Transplant & Missing Children Statistics

BBC World Service, April 18, 2015
Hosts: Hannah Moore & Ruth Alexander

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Episode Overview

This episode of More or Less, hosted by Hannah Moore and Ruth Alexander, addresses two major statistical topics:

1. The realities and risks surrounding liver transplants, particularly live liver donations, prompted by a listener's personal story.
2. The widely circulated statistics about missing children in the US, examining what they truly mean and whether they are as alarming as often presented in the media.

The hosts guide listeners through expert interviews, critically analyze prominent numbers, and debunk misunderstandings around these subjects.

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1. Liver Transplant Statistics: Risks and Realities

Context:
Listener Henry, aged 21, has been listed for a liver transplant. His brother has offered to be a living donor, but they want clarity on the risks involved.

Key Discussion Points & Insights

• The Organ Donor Pool in the UK

  • 21 million people in the UK are registered organ donors (1/3rd of the population) [00:42].
  • However, only 1% die in circumstances allowing their organs to be used (e.g., car accidents, brain haemorrhage).

• Waiting Time for Deceased Donor Liver Transplant:

  • Prof. James Neuberger (Consultant in Liver Medicine, Queen Elizabeth Hospital, Birmingham):
    • "The majority of people wait between 60 and 220 days, depending on the blood group." [01:53]
    • For B negative blood type (Henry's group): "The average wait...is about 220 days. But there is considerable variation." [02:10]
    • Notably: "Between 15 to 20% of those listed for a transplant will die or become too ill...So that's nearly one in five people on the waiting list..." [02:21]

• Live Liver Transplant:

  • Live donor is often a close family member or friend; allows surgery to be performed quicker [01:19].
  • Risks to the Donor:
    • Prof. Neuberger: "The risks that are quoted to the potential donors are a risk of death of about 1 in 250." [02:54]
    • Additional risks: A very small number of donors have needed a liver transplant themselves due to loss of too much liver tissue.
    • Prof. Neuberger: "But the really scary figure is that risk of death of 1 in 250." [03:10]

• Why Choose Live Donation?

  • Prof. Neuberger: "Primarily, I think because of the waiting time. And certainly if any of my close family needed an urgent liver transplant, I would consider very carefully organ donation for them." [03:24]

Notable Quotes

• Prof. Neuberger:

  "The sad fact is that between 15 to 20% of those listed for a transplant will die or become too ill...So that's nearly one in five people on the waiting list." [02:21]

• Prof. Neuberger:

  "The risks that are quoted...are a risk of death of about 1 in 250...But the really scary figure is that risk of death of 1 in 250." [02:54, 03:10]

[Key Segment Timestamps]

• UK organ donation stats: [00:42]
• Waiting times for liver transplant: [01:53]
• Risks of live liver donation: [02:54]
• Why choose live donation: [03:24]

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2. Unpacking "Missing Children" Statistics in the US

Context:
A CBS News Channel campaign claims a child goes missing every 90 seconds in the US, a figure echoed and amplified by other media ("every 40 seconds" per Parents.com). The program investigates what underpins these claims.

Key Discussion Points & Insights

• Defining "Missing"

  • The headline numbers conflate many different scenarios: kidnappings, runaways, misunderstandings, custody disputes [05:24].
  • Many cases are "benign missing"—children thought missing briefly due to delay or confusion [05:49].

• What the Numbers Really Show

  • The Major US Study (2002):

    • The National Incident Studies of Missing Observations... found 800,000 reports of missing children in 1999 [04:28].
    • Equivalent to "one in 90 children reported missing in a single year" [04:52].
    • Nearly half were "benign missing" — children unaccounted for only briefly but not in real danger [05:49].

  • Actual Stranger Kidnappings:

    • Prof. David Finkelhaugh (Co-author, National Incident Studies of Missing Children):
      • "There are only about 115 of these...what we called stereotypical kidnappings that had occurred over the course of a year." [06:19]
      • Defined as abductions by strangers, lasting overnight, or involving significant harm/distance.

  • Most Common Cases:

    • Largest group: Runaways, usually short-term [06:48].
    • Stereotypical abductions by strangers are very rare.

• Why Are Old Stats Still Quoted?

  • Media still uses data from the 2002 report (focused on 1999), as newer national studies haven't been conducted due to cost [07:10].

• Signs of Improvement

  • Prof. Finkelhaugh anticipates fewer missing children now than in 1999, citing:
    • Mobile phones, which reduce "benign" cases.
    • Declines in crime, including crimes against children [07:40].
  • FBI data reflects this: missing persons reports peaked at nearly 1 million in 1997; by 2014, down to ~600,000—a 25% drop [08:21].

Notable Quotes

• Prof. Finkelhaugh:

  "The number of kids who are actually kidnapped by strangers in these kind of most horrific kinds of situations that parents worry about, that's quite small. There are only about 115 of these...over the course of a year." [06:19]

• Prof. Finkelhaugh:

  "The landscape has changed dramatically...the biggest change has been the acquisition of cell phones...benign missing episodes are likely to have declined a great deal because parents can call and find out what's happening." [07:40]

• Ruth Alexander:

  "So the latest evidence suggests that the number of children going missing is likely to be lower than the headlines suggest." [09:04]

[Key Segment Timestamps]

• Introduction to "Every 90 Seconds" claim: [03:52]
• What "missing" means and breakdown: [04:52]–[06:11]
• Prof. Finkelhaugh's kidnapping breakdown: [06:19]
• Reasons for persistence of old stats: [07:10]
• FBI data and trends: [08:21]

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Memorable Moments

• Hosts Unpack Headlines:
  Ruth and Hannah clarify that frightening media numbers about missing children usually don't mean kidnapping, but include routine misunderstandings or brief runaways [05:24].

• Expert Voices Address Public Fear:
  Prof. Neuberger and Prof. Finkelhaugh both address the difference between "headline numbers" and the much lower risk faced by most people—whether in medical crises or public safety concerns.

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Summary and Takeaway

This episode shines a light on the gap between alarming statistics as they appear in media and the nuanced realities behind them.

• For liver transplants, the risk to a living donor, while significant, is rare, and long waits for a liver are common, emphasizing the ongoing need for more donors.
• For missing children statistics, most cases are less severe than the public fears, and sensational numbers rarely represent abductions. Actual stranger kidnappings are extremely rare and trends indicate improvement over time.

Final Note:
The hosts' thorough, compassionate exploration encourages listeners not just to question big statistics, but to seek the context and definitions that turn scary numbers into meaningful insight.

Transcript

[Ruth Alexander]

This is the short edition of More or Less, first broadcast on the BBC World Service.

[BBC Announcer]

Thank you for downloading from the BBC. For details of our complete range of podcasts and our terms of use, go to bbcworldservice.com podcasts

[Hannah Moore]

hello, and welcome to More or Less on the BBC World Service. I'm Hannah Moore.

[Ruth Alexander]

And I'm Ruth Alexander. We're always pleased when the More or Less inbox pings with a question from a loyal listener like Henry, who sent this to More or [e-mail].

[Hannah Moore]

i'm 21 years old and I've just

[Professor David Finkelhaugh]

been listed here for a liver transplant. My older brother has offered to be

[Ruth Alexander]

a live liver donor.

[BBC Announcer]

Could you help us make sense of the risks?

[Hannah Moore]

Now, let's put this into context. Henry's one of around 500 people in the UK currently waiting for a liver transplant. And it's a scary time for them all. More than a third of the UK population, 21 million people, are registered as organ donors, meaning they've given consent for doctors to transplant their organs after they've died. It sounds a lot, but only 1% of people in the UK die in circumstances where their organs could actually be used. Often that's a car accident or brain haemorrhage, and doctors have to find the right match. Unfortunately for some, that never happens.

[Ruth Alexander]

But there's the option of a live liver transplant. That's when part of a liver is taken from someone who's living normally, a close relative or friend. And a live transplant means the operation can often be done more quickly. But it does carry its own risk. That friend or relative, in Henry's case, his brother, could die as a result of the procedure.

[Hannah Moore]

So it's understandable he wants to weigh up the options and I found the expert to help. Professor James Neuberger is a consultant in liver medicine at Queen Elizabeth Hospital in Birmingham in the uk. I asked him what factors affect the waiting time for a liver.

[Professor James Neuberger]

The majority of people wait between 60 and 220 days, depending on the blood group.

[Hannah Moore]

Our listener, Henry, is B negative blood type. How long, on average do people in that group have to wait for a donor liver?

[Professor James Neuberger]

The average wait for a blood group B recipient is about 220 days. But there is considerable variation. Some people wait a lot less and others have to wait a lot longer. The sad fact is that between 15 to 20% of those listed for a transplant will die or become too ill or and so removed from the transplant list. So that's nearly one in five people on the waiting list and it again emphasises the need for more donors. Some people who are living may wish to donate part of their liver, usually to a close family member or very close family friend.

[Hannah Moore]

What's the risk to the donor?

[Professor James Neuberger]

The risks that are quoted to the potential donors are a risk of death of about 1 in 250. There are other potential risks. Very small number have needed a liver transplant because too much liver from the donor has been taken away. But the really scary figure is that risk of death of 1 in 250.

[Hannah Moore]

So why might somebody go through with a live liver donation instead of having an organ from somebody who's deceased?

[Professor James Neuberger]

Primarily, I think because of the waiting time. And certainly if any of my close family needed an urgent liver transplant, I would consider very carefully organ donation for them.

[Hannah Moore]

So for Henry, it could be a long wait of around 220 days if his brother can't act as a living donor before then. Henry, we hope everything goes really well with your treatment and please keep us updated and thank you to Professor Neuberger.

[Ruth Alexander]

When we hear news reports of a child going missing, we often jump to the worst conclusions. The CBS News Channel, Wu USA recently launched a safety awareness campaign called Every90Seconds, which is based on the claim that a child goes missing every one and a half minutes in the US every 90 seconds. It's a figure that's been widely quoted in the media over the past few years. And it sounds alarming because you might reasonably assume it refers to kidnappings. But does it?

[Hannah Moore]

The last major study on missing children in the US was carried out way back in 2002.

[Ruth Alexander]

It's got a really long title, hasn't it?

[Hannah Moore]

Yes, the National Incident Studies of Missing Observations. Abducted, Runaway and Thrown Away Children. Funded by the US Department of Justice, it compiled data from a range of sources, including police reports, interviews with parents and children. And it found there'd been 800,000 reports of missing children in the US during the year it focused on 1999.

[Ruth Alexander]

In that year, there were about 70 million under 18s in America as a whole. So that's one in 90 children reported missing in a single year. And it may sound like a high number, but what exactly does it mean when we say a child is missing?

[Hannah Moore]

Well, media reports on missing children often don't make that definition clear. For example, the headline figure in an article on Parents.com, one of the most popular parenting sites in the U.S. claims every 40 seconds in the United States, a child becomes missing or is abducted.

[Ruth Alexander]

So the news channel says a child goes missing every 90 seconds. But parents.com says it happens even more often than that. Every 40 seconds. Get, you know, it all sounds very alarming, these statistics, but there are lots of reasons why a child may go missing. They may have run away from home or failed to come home on time, incidences which are of course, worrying, but very different to their being kidnapped by a stranger in the street.

[Hannah Moore]

In fact, the Department of Justice study found almost half of those cases were what it calls benign missing. That means their parent or guardian thought they were missing. Maybe they didn't come home on time or there was some confusion over where they were meeting, but they turned up soon afterwards.

[Ruth Alexander]

So in other words, the majority of children reported missing weren't really missing at all.

[Hannah Moore]

Professor David Finkelhaugh co authored the report. He's director of the Crimes Against Children Research Centre at the University of New Hampshire.

[Professor David Finkelhaugh]

In the US the missing child concept is widely misunderstood. The number of kids who are actually kidnapped by strangers in these kind of most horrific kinds of situations that parents worry about, that's quite small. There are only about 115 of these, what we called stereotypical kidnappings that had occurred over the course of a year. We define a stereotypical stranger kidnapping as one that lasts at least overnight or taking the child a distance of 50 miles or more, or involves an attempt to keep the child permanently or in which the child is killed. We also found that the largest category of the missing children were children who had run away from home, usually for a short period of time. They had to be gone overnight to be counted, but they didn't tend to be missing all that long.

[Ruth Alexander]

So we wondered why these figures are still being widely quoted 13 years after the Justice Department report was published. And actually the data it is 16 years old. Well, US Congress has said missing children statistics should be gathered and assessed regularly, but it's not been happening, basically because of money. It's an expensive thing to do.

[Hannah Moore]

Professor Finkelhaugh is in the process of preparing a new report, though, due out later this year. He says there's good reason to think the number of missing children will have fallen.

[Professor David Finkelhaugh]

The landscape has changed dramatically and the biggest change has been the acquisition of cell phones. So, for example, these benign missing episodes are likely to have declined a great deal because parents can call and find out what's happening. Similarly, running away is probably less common. We suspect that's true from other data. Then, in addition to that, in the United States and to some extent in other places in the world, crime has declined tremendously. Crimes against children are down. Sexual assaults are down, homicides are down. So it's very likely that some of these episodes that are motivated by criminal intent are also down as well.

[Ruth Alexander]

But while we're waiting for Professor Finkelhohr's report to come out, there is other information we can look at. The U.S. police, Federal Bureau of Investigation, the FBI records missing people reports from across the states, and their data does play out his predictions. The number of reports reached a 23 year high in 1997 at almost a million, but they've gradually been decreasing since then. In 2014, there were around 600,000 reports of people going missing, the majority of whom were under 18. Now that's a quarter less than the old figures which the media are still relying on. So the latest evidence suggests that the number of children going missing is likely to be lower than the headlines suggest.

[Hannah Moore]

Our thanks to Professor Finkelhaugh. Keep your questions and comments coming to more or lessbc.co.uk and listen to past episodes at our website, BBC.commoreorless

[BBC Announcer]

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