Abstract 13291: Assessing Organ Procurement Organization Performance Across the Different Routes to Deceased Organ Donation

Abstract

Introduction: Organ procurement organizations (OPOs) are responsible for organ donor recruitment which can occur via donor registries or next-of-kin consent. Donor conversion rate is a metric used to assess OPO performance, reflecting the number of donors per eligible death. However, OPOs are not directly responsible for the success of donor registration. This study aims to describe the trends in donor recruitment via registries and next-of-kin consent, report the relationship between consent mechanisms, and assess the variability across OPOs. Methods: The SRTR database was queried for all eligible deaths (2008-2019), stratified by consent mechanism (Fig A). Trends were assessed over time. Multivariable logistic regression models adjusted for population demographic differences. Linear regression assessed the association between donor registration and next-of-kin consent at the OPO level. The probability of next-of-kin consent was assessed across OPOs after adjusting for population differences. Results: Donor registration has increased over time with a concurrent decrease in next-of-kin consent (Fig B & C). At the OPO level, an increase in donor registration is associated with lower next-of-kin consent rates. However, there are OPOs that demonstrate a high probability of next-of-kin consent in the face of highly successful donor registration (Fig D). The success of next-of-kin consent is highly variable across OPOs, even after adjusting for population demographic differences (Fig E). Conclusions: Utilization of registries for donor recruitment has increased over time while next-of-kin consent has declined. Donor conversion rate provides an incomplete assessment of OPO performance and may artificially favor OPOs in regions with highly successful donor registration practices. There is significant variability across OPOs in next-of-kin consent. Knowledge of detailed donor recruitment data may allow OPOs to better target areas for improvement.