*Purpose: Organs suitable for donation are a scarce resource and maximizing the use of available donor organs is a public health priority. Transplantable organs may currently be going unused due to bias against older donors. We sought to determine whether there is a left digit bias present in donated organs offered and accepted for donors entering a new decade of age, i.e. 70 compared to 69, a bias which has been shown to be important in other domains of healthcare.

*Methods: Potential deceased organ donors (n=105,387) who had any organs offered for transplantation from 2010-2019 Organ Procurement and Transplantation Network data were analyzed. Donors were identified 1 year before and after a decade altering birthday. Primary outcomes were whether a potential donor had any organs offered and accepted for transplantation.

*Results: Donors 1 year before (n=2018) and after (n=1585) their 60^th and 1 year before (n=705) and after (n=504) their 70^th birthday were compared. At age 70 there was a 5.4% decrease in the probability of any organ placement for donors having entered a new decade of life (95% CI 1.1-9.7). There was a decrease of 0.25 organs (95% CI 0.13-0.37) after a donor’s 70^th birthday. For potential liver donors at age 70 there was a 5.3% decrease in the probability of organ placement for donors entering a new decade of life (95% CI -0.02-10.7%) and a 7.0% decrease for potential kidney donors (95% CI 0.4-13.6%).

*Conclusions: There was a significant left digit bias in the acceptance of any organs for transplantation at ages 60 and 70 as well as a significant bias in the acceptance of a kidney at age 70. This bias was seen at both selection and acceptance steps in the transplantation process. Targeting this bias is an opportunity to increase the use of potentially transplantable organs in the US and expand the donor pool.

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