Organ Donation and Transplantation in US States and Europe – Is There a Benefit to Opting Out?
1Cardiovascular & Thoracic Surgery, The University of Texas Southwestern Medical Center, Dallas, TX
2Southwest Transplant Alliance, Dallas, TX
3OneLegacy, Los Angeles, CA.
Meeting: 2018 American Transplant Congress
Abstract number: D280
Keywords: Outcome, Public policy, Resource utilization
Session Information
Session Name: Poster Session D: Late Breaking
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
European reports suggest improved transplant rates in countries with Opt-out or presumed consent donation. Legislation to adopt Opt-out donation has been introduced in several US states. The purpose of this study was to compare donation and transplant rates between European countries (based on consent system) and populous US states to assess implications for Opt-out donation in the US.
2016 donation and transplant data were obtained from the Organ Procurement and Transplantation Network and the International Registry in Organ Donation and Transplantation Newsletter for US states and European countries, respectively. Only US states and European countries with populations of 10 million or greater and donation rates of at least 10 donors per million (DPM) were included. Donation (with and without death rate adjustment) and transplant rates were reported per million population. Groups were compared by weighted means analysis of variance.
Most donation and transplant metrics except for living donation were increased in European Opt-out compared to European Opt-in countries though none reached statistical significance. US states' rates were significantly higher for the majority of parameters compared to all European countries. See Table.
| Variable | US States | Opt-in Europe | Opt-out Europe |
| Deceased DPM | 30.0[dagger] | 15.3 | 27.6 |
| Death Rate | 7.9* | 10.5 | 10.0 |
| Deceased nDPM | 35.9[dagger] | 14.3 | 26.6 |
| Living DPM | 17.6# | 13.5 | 6.5 |
| Total DPM | 47.6* | 28.8 | 34.0 |
| Total nDPM | 53.5* | 27.9 | 33.1 |
| Kidney Tx/M | 60.9[dagger] | 38.9 | 48.1 |
| Liver Tx/M | 24.7[dagger] | 12.1 | 19.2 |
| Heart Tx/M | 10.60* | 3.40 | 5.5 |
| Lung Tx/M | 8.4 | 3.5 | 4.36 |
| Pancreas Tx/M | 2.8# | 1.9 | 1.5 |
| Total Tx/M | 107.5* | 59.8 | 78.7 |
| *-p<.05 vs both Opt-in and Opt-out, [dagger]-p<.05 vs Opt-in, #-p<.05 vs Opt-out | |||
Donation and transplantation rates tended to be higher in European Opt-out compared to Opt-in countries but were lower than in US states. This study does not support Opt-out donation as a mechanism to increase the number of transplants performed in the US.
Keywords: Donation, Public policy, Resource utilization, Outcome.
CITATION INFORMATION: Vela R. J., Pruszynski J., Mone T., Niles P., Peltz M. Organ Donation and Transplantation in US States and Europe – Is There a Benefit to Opting Out? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Vela RJ, Pruszynski J, Mone T, Niles P, Peltz M. Organ Donation and Transplantation in US States and Europe – Is There a Benefit to Opting Out? [abstract]. https://atcmeetingabstracts.com/abstract/organ-donation-and-transplantation-in-us-states-and-europe-is-there-a-benefit-to-opting-out/. Accessed July 10, 2025.« Back to 2018 American Transplant Congress