Pennsylvania's voluntary benefits program: evaluating an innovative proposal for increasing organ donation.

Abstract

Solid organ transplants have saved thousands of lives since the development of effective immunosuppressants in the early 1980s. But transplantable organs are still desperately scarce. The number of persons needing transplants continues to grow faster than the supply of available organs. 1 For example, from 1990 to 1996 the number of liver transplants nationwide increased by 51 percent, and the number of donors increased by 55 percent. Yet during the same time period the number of persons added to the liver transplant waiting list increased by more than 500 percent, according to data from the United Network for Organ Sharing (UNOS). In the United States, cadaveric organ donation depends primarily on altruistic acts by next of kin. Many states encourage people to indicate their willingness to donate on their driver’s licenses. More recently states have begun to require transplant professionals to discuss donation with potential donors’ families. Nevertheless , only half of all potential donors in the United States become actual donors, despite vigorous and sustained private and government efforts to increase organ donation. 2 Demographic data indicate that persons of color and lower educational, socioeconomic, or health status are less enthusiastic about donation and, in turn, are less likely to consent to donation. 3