Sammy Saab1,2,3,4, Satvir S Saggi5, Mizna Akbar5, Gina Choi6,5. 1. Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA. SSaab@mednet.ucla.edu. 2. Department of Surgery, University of California at Los Angeles, Los Angeles, CA, USA. SSaab@mednet.ucla.edu. 3. Department of Nursing, University of California at Los Angeles, Los Angeles, CA, USA. SSaab@mednet.ucla.edu. 4. Pfleger Liver Institute, UCLA Medical Center, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA. SSaab@mednet.ucla.edu. 5. Department of Surgery, University of California at Los Angeles, Los Angeles, CA, USA. 6. Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA.
Abstract
BACKGROUND: There is currently an inadequate supply of allografts to meet the number of transplant candidates worldwide. A number of controversial policies, including implementation of a presumed consent organ donation system, have been considered to rectify the organ donation crisis. AIMS: A secondary retrospective data analysis aimed to assess the impact of switching to a presumed consent organ donation model on organ donation rates. METHODS: Deceased organ donation rates were compared before and after countries adopted presumed consent. RESULTS: Six countries met entry criteria. All six countries had an increase in liver donation rates, while 4 out of the six countries had an increase in kidney donation rates. The overall mean (± SD) liver donation rate was 3.23 (± 0.97) per million population (pmp) before the transition and 6.46 (± 1.81) pmp after the transition (p < 0.0001). The overall mean (± SD) kidney donation rate was 17.94 (± 3.34) pmp before the transition and 26.58 (± 4.23) pmp after the transition (p < 0.0001). The percentage increase in liver and kidney donation rates varied among countries, ranging from 28 to 1186%. CONCLUSION: The transition from explicit to presumed consent was associated with a significant increase in liver donation rates in all countries that met our criteria, while the effect on kidney donation rates was partially realized. Although presumed consent alone is unlikely to explain the increase in donation rates, the adoption of such a policy may prove to be a worthwhile risk for countries experiencing consistently low organ donation rates.
BACKGROUND: There is currently an inadequate supply of allografts to meet the number of transplant candidates worldwide. A number of controversial policies, including implementation of a presumed consent organ donation system, have been considered to rectify the organ donation crisis. AIMS: A secondary retrospective data analysis aimed to assess the impact of switching to a presumed consent organ donation model on organ donation rates. METHODS: Deceased organ donation rates were compared before and after countries adopted presumed consent. RESULTS: Six countries met entry criteria. All six countries had an increase in liver donation rates, while 4 out of the six countries had an increase in kidney donation rates. The overall mean (± SD) liver donation rate was 3.23 (± 0.97) per million population (pmp) before the transition and 6.46 (± 1.81) pmp after the transition (p < 0.0001). The overall mean (± SD) kidney donation rate was 17.94 (± 3.34) pmp before the transition and 26.58 (± 4.23) pmp after the transition (p < 0.0001). The percentage increase in liver and kidney donation rates varied among countries, ranging from 28 to 1186%. CONCLUSION: The transition from explicit to presumed consent was associated with a significant increase in liver donation rates in all countries that met our criteria, while the effect on kidney donation rates was partially realized. Although presumed consent alone is unlikely to explain the increase in donation rates, the adoption of such a policy may prove to be a worthwhile risk for countries experiencing consistently low organ donation rates.
Authors: Lucy D Horvat; Meaghan S Cuerden; S Joseph Kim; John J Koval; Ann Young; Amit X Garg Journal: Ann Intern Med Date: 2010-11-16 Impact factor: 25.391
Authors: John P Duffy; Kenneth Kao; Clifford Y Ko; Douglas G Farmer; Sue V McDiarmid; Johnny C Hong; Robert S Venick; Susan Feist; Leonard Goldstein; Sammy Saab; Jonathan R Hiatt; Ronald W Busuttil Journal: Ann Surg Date: 2010-10 Impact factor: 12.969
Authors: Robert M Merion; Douglas E Schaubel; Dawn M Dykstra; Richard B Freeman; Friedrich K Port; Robert A Wolfe Journal: Am J Transplant Date: 2005-02 Impact factor: 8.086
Authors: Kirsten Regalia; Patricia Zheng; Stefan Sillau; Anuj Aggarwal; Oliver Bellevue; Oren K Fix; Jennifer Prinz; Susan Dunn; Scott W Biggins Journal: Dig Dis Sci Date: 2014-02-12 Impact factor: 3.199
Authors: Amanda M Rosenblum; Lucy D Horvat; Laura A Siminoff; Versha Prakash; Janice Beitel; Amit X Garg Journal: Nephrol Dial Transplant Date: 2011-11-25 Impact factor: 5.992
Authors: Luke J DeRoos; Wesley J Marrero; Elliot B Tapper; Christopher J Sonnenday; Mariel S Lavieri; David W Hutton; Neehar D Parikh Journal: JAMA Netw Open Date: 2019-10-02
Authors: Jacqueline M Smits; Jens Gottlieb; Erik Verschuuren; Patrick Evrard; Rogier Hoek; Christiane Knoop; György Lang; Johanna M Kwakkel-van Erp; Robin Vos; Geert Verleden; Benoit Rondelet; Daniel Hoefer; Frank Langer; Rene Schramm; Konrad Hoetzenecker; Diana van Kessel; Bart Luijk; Leonard Seghers; Tobias Deuse; Roland Buhl; Christian Witt; Agita Strelniece; Dave Green; Erwin de Vries; Guenter Laufer; Dirk Van Raemdonck Journal: Transpl Int Date: 2020-02-13 Impact factor: 3.782
Authors: Vanessa Silva E Silva; Janine Schirmer; Bartira D'Aguiar Roza; Priscilla Caroliny de Oliveira; Sonny Dhanani; Joan Almost; Markus Schafer; Joan Tranmer Journal: Can J Kidney Health Dis Date: 2021-02-20
Authors: Sameera Senanayake; Helen Healy; Steven M McPhail; Keshwar Baboolal; Sanjeewa Kularatna Journal: Appl Health Econ Health Policy Date: 2022-07-18 Impact factor: 3.686