Organ Donation Rates And Transplantation Activity Comparing Opt-out Versus Opt-in Systems: A Cross-sectional Study Of Oecd Countries
1University of Birmingham, Birmingham, United Kingdom, 2Queen Elizabeth Hospital, Department of Nephrology and Transplantation, Birmingham, United Kingdom
Meeting: 2019 American Transplant Congress
Abstract number: D218
Keywords: Donation
Session Information
Session Name: Poster Session D: Non-Organ Specific: Public Policy & Allocation
Session Type: Poster Session
Date: Tuesday, June 4, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: The aim of this study was to compare organ donation and transplantation rates between opt-out versus opt-in countries to investigate for any significant difference in the contemporary era.
*Methods: Data was analysed for 35 countries registered with the Organisation for Economic Co-operation and Development (17 countries classified as opt-out, remaining 18 classified as opt-in) and obtained organ donation/transplantation rates for 2012 – 2016 from the Global Observatory for Donation and Transplantation. Supplementary socio-economic and health data was obtained from a number of data repositories. Main outcomes measures: organ donation rates (living and deceased), kidney transplant activity, non-renal transplant activity, total solid organ transplantation activity.
*Results: Comparing opt-out to opt-in countries, we observed no significant difference in deceased organ donors (per million populations) (20.3 versus 15.4 respectively, p=0.195) but opt-out countries had significantly less living organ donors (4.8 versus 15.7 respectively, p<0.001). However, no significant difference was observed in kidney transplantation (35.2 versus 42.3 respectively, p=0.405), non-renal transplantation (28.7 versus 20.9 respectively, p=0.606) or total solid-organ transplantation (63.6 versus 61.7 respectively, p=0.909) activity comparing opt-out versus opt-in countries. In a multivariate linear regression model, adjusted for country-specific variables, opt-out was independently predictive of living organ donor rates (ß=-9.97 [95% CI: -16.50 to - 3.49], p=0.004) but not for deceased donors or any transplantation activity.
*Conclusions: Apart from lower living donor rates, our data demonstrates no contemporary difference in deceased donor rates or any form of solid organ transplantation activity between opt-out versus opt-in countries. Rather than fixating upon organ donation registration systems, this work suggests healthcare providers should focus on actual barriers to increasing organ donation such as cognitive obstacles to securing consent and resource challenges prohibiting organ donation.
To cite this abstract in AMA style:
Arshad A, Babiker M, Anderson B, Sharif A. Organ Donation Rates And Transplantation Activity Comparing Opt-out Versus Opt-in Systems: A Cross-sectional Study Of Oecd Countries [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/organ-donation-rates-and-transplantation-activity-comparing-opt-out-versus-opt-in-systems-a-cross-sectional-study-of-oecd-countries/. Accessed May 18, 2025.« Back to 2019 American Transplant Congress