Abstract
Waiting times for organs in the United States are long and vary widely across regions. Donor registration can increase the number of potential donors, but its effect on the actual number of organ transplants depends upon several factors. First among these factors is that deceased donor organ donation requires both that death occur in a way making recovery possible and that authorization to recover organs is obtained. We estimate the potential donor death rate and donor authorization rate conditional on potential donor death by donor registration status for each state and for key demographic groups. With this information, we then develop a simple measure of the value of a new donor registration. This combined measure using information on donor authorization rates and potential death rates varies widely across states and groups, suggesting that focusing registration efforts on high-value groups and locations can significantly increase the overall number of donors. Targeting high-value states raises 26.7 percent more donors than a uniform, nationwide registration effort. Our estimates can also be used to assess alternative, but complementary, policies such as protocols to improve authorization rates for non-registered potential donors.
Highlights
As of July 1, 2019, there were 113,312 candidates for an organ transplantation on waiting lists in the United States
We use the Standard Transplant Analysis and Research (STAR) files provided by the United Network for Organ Sharing (UNOS) as contractor for the Organ Procurement and Transplantation Network (OPTN)
Confidence intervals for p1 (Registered Potential Donor Death rate), p2 (Registered Donor Authorization rate), q1 (Non-Registered Potential Donor Death rate) and q2 (Non-Registered Donor Authorization rate) for each state are found in Tables 4 and 5 in the Appendix
Summary
As of July 1, 2019, there were 113,312 candidates for an organ transplantation on waiting lists in the United States. The time on waiting lists can be quite long and varies by organ type. Donor registration efforts attempt to increase awareness of the need for organ donors and to expand the pool of individuals who have authorized organ donation [2,3,4,5,6]. Laws such as the state-level Uniform Anatomical Gift Act provide clarity and speed in the processing of available organs and set up guidelines for maintaining databases of registered donors [4, 7]. Training of hospital staff in protocols for obtaining authorization from family at time of death are employed [8,9,10,11,12]
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