Introduction: Organ transplantation has proven to be the cost-effective alternative to several end-stage organ diseases. While diseased kidneys can receive kidney replacement therapy and still have a reasonable life expectancy, the rest of the diseased organs depend on their transplant to live. As dead donors can provide 2 kidneys for transplantation, the scarcity of organ donors' concern has been on single organs rather than on kidneys. But how is the real transplant access to each organ? We studied the case of Chile, a high-income South American country that has a very low organ donation rate of 7.8 donors pmp.
Methods: For the period of time of 2018-2023, we obtained monthly figures of patients in the waiting list (WL) for all five solid organs that have transplantation programs in Chile: kidney, liver, heart, lungs, and pancreas) from the National Public Health Institute. From that same institution, we obtained monthly organ transplants by organ. We obtained monthly organ donors from the National Procurement and Transplantation Coordination from the Ministry of Health. To compare all these figures, we used descriptive statistics: means and standard deviations, and t-student tests.
Results: On average, an organ donor in Chile donates 1.53 ± 0.3 kidneys. To compare it to the rest of the organs we considered each pair of kidneys as one. On average, an organ donor provides 0.77 ± 0.15 kidney, 0.76 ± 0.17 liver, 0.2 ± 0.13 heart, 0.13 ± 0.1 lung, and 0.05 ± 0.07 pancreas, where the difference between kidney and liver is not significant (p-value = 0.86). Considering patients on WL, for every 100 patients on WL the average transplantation rate was 1.72 ± 0.89 for kidney, 7.61 ± 3.18 for liver, 15.4 ± 9.67 for heart, 4.75 ± 4.05 for lungs, and 2.64 ± 3.7 for pancreas. The lowest transplant access rate is for the kidney. In fact, when comparing the rates for kidney and pancreas, which is the following lowest rate, we found significant differences (p-value = 0.043), showing that the kidney has, indeed, the lowest access to transplantation. 
Conclusion: As we see, and opposed to what it is commonly thought, the highest access to transplantation is for heart recipients, and the lowest access to transplantation is for those waiting for a kidney. The main reasons for this is how the WL for each organ is managed, intrinsic differences of the chronic diseases that lead to be listed on WL and its treatments, the number of kidney transplantation centers that can contribute to the WL compared to the rest of the organs (21 vs 11, 8, 4, and 3 respectively), and the scarce amount of organ donors that Chile produces to try to meet the organ demand. Using these results, we may argue that the kidney transplantation centers are more focused on providing access to the WL than to the desired transplant, producing a huge disparity in access to transplantation, and false illusions on the 1900 patients on WL for a kidney.