Adoption of ride share services associated with decreased organ donor availability

Abstract

IntroductionRecent single center studies have shown an association between the introduction and adoption of ride sharing services and a significant reduction in alcohol-related motor vehicle collisions and fatalities at urban trauma centers. There is a lack of studies that have evaluated the effect of the introduction and widespread adoption of ride sharing services on the number of organ donors available from motor vehicle accidents (MVAs) and the effect on the overall donor pool. We hypothesize that the number of deceased donors from MVAs has decreased with the introduction of ride sharing. MethodsThe United Network for Organ Sharing (UNOs) database was retrospectively reviewed from September 29,1987 to June 30, 2022 for deceased donors. Only pediatric donors were excluded (age<15). Donors were analyzed by circumstance of death, which included: MVA, suicide, homicide, non-MVA accidents, natural causes, and other. The launch of the major ride sharing service in the United States occurred on July 15, 2010. This service was available in 100 cities in April 2014 and in 500 cities in December 2016. Data were analyzed in a continuous manner and then 4 major adoption periods were considered: pre-launch, launch to narrow adoption, narrow to wide adoption, and post wide adoption. Results218,606 deceased donors had the circumstance of death data available and were included in our analysis. The mean deceased donor age was 42 years, 60% of donors were male, and 71% were white. MVA proportion of death decreased 5% (p<0.001) from the launch to narrow adoption period (16%) compared to pre-launch (21%). Another 2% (p<0.001) decrease occurred during the narrow to wide adoption period (14%). An additional 2% (p<0.001) drop occurred after wide adoption (12%). Figure 1 shows stacked percentages of the various circumstances of death in a continuous manner. Of note: homicides, suicides, and non-MVA accidents were not consistently recorded until 1994, and natural causes until 2001. This graph demonstrates a notable drop in MVA percentages beginning after the launch of ride sharing with steady declines continuing to the period of wide adoption. While absolute numbers of MVA donors have steadily increased since 2014 and had steady numbers before, the other deceased donor categories have increased at a higher rate. ConclusionThe invention and adoption of ride sharing services has decreased the proportion of organ donors from MVAs. The overall number of donors from MVAs, donors from all other causes, and the total number of deceased donors increases each year.