Increasing Organ Supply in the US: A Systematic Review of Presumed Consent vs. Informed Consent (2006-2016).
1University of South Florida Morsani College of Medicine, Tampa, FL
2Stetson University College of Law, Gulfport, FL
3Transplant &
Specialty Services, Tampa General Hospital, Tampa, FL
4University of Cambridge School of Clinical Medicine, Cambridge, Cambridgeshire, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: 285
Keywords: Cadaveric organs, Donation, Economics, Public policy
Session Information
Session Name: Concurrent Session: Transplant Regulation and Management: Allocation, Access and Other Transplant Management Topics
Session Type: Concurrent Session
Date: Monday, May 1, 2017
Session Time: 2:30pm-4:00pm
Presentation Time: 3:06pm-3:18pm
Location: E451b
Purpose: Literature was systematically reviewed from 2006 to 2016 to assess the effectiveness of presumed consent vs. informed consent on increasing the deceased donor organ supply.
Methods: A synonym table was created to include all phrases referring to organ donation, presumed consent, and informed consent. A comprehensive search of electronic databases PubMed and Embase were conducted with the search criteria outlined by two independent reviewers. Primary outcomes were deceased donation rate (DDR) and deceased transplantation rate (DTR) with results typically reported per million population (PMP). The NHS and Welsh Government were contacted for current and prior rates of deceased donation and transplantation based on a change in law from informed consent to presumed consent in 2015. Secondary outcome measures were deceased donation and transplantation figures from Wales, UK.
Results: 2,628 articles were returned from the search with 6 primary research articles meeting screening criteria. Heterogeneity of study design, methods, and analytical methods prevented the ability to conduct a meta-analysis of study results. 4 studies reported DDR with presumed consent vs. informed consent associated with a 21-76% increase in DDR PMP (p<0.05). 2 studies reported DTR for kidneys with presumed consent vs. informed consent associated with an 8.7 and 11.92 increase in DTR PMP (p<0.01). Data from Wales, UK during the first 6 months of presumed consent (2015-16) vs informed consent (2014-15) showed a 50% increase in deceased donors (31 vs. 21) with 53% of transplants from presumed donors (32 vs. 28).
Conclusions: Although data is limited, this systematic review shows that presumed consent has a significant effect on deceased organ donation and transplantation rates when compared to informed consent. Informed consent is the system currently used in the US. If consent to deceased organ donation was increased to the 75th percentile across the US, more than 1,000 additional solid organs would be available for transplant consideration in the US every year.
CITATION INFORMATION: Ahmad M, Hanna A, Mohamed A, Mhaskar R, Jarmi T, Schlindwein A, Pley C, Bahner I. Increasing Organ Supply in the US: A Systematic Review of Presumed Consent vs. Informed Consent (2006-2016). Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Ahmad M, Hanna A, Mohamed A, Mhaskar R, Jarmi T, Schlindwein A, Pley C, Bahner I. Increasing Organ Supply in the US: A Systematic Review of Presumed Consent vs. Informed Consent (2006-2016). [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/increasing-organ-supply-in-the-us-a-systematic-review-of-presumed-consent-vs-informed-consent-2006-2016/. Accessed May 25, 2025.« Back to 2017 American Transplant Congress