*Purpose: Historically, deceased organ donation rates have varied across racial/ethnic groups within the US. To address these differences, the transplant community has investigated select minority group beliefs around donation and implemented donor and donor-family centric interventions. There has been no contemporary evaluation of changes in donation rates among racial/ethnic groups at the population-level.

*Methods: We used SRTR and CDC WONDER data to identify eligible deaths that occurred in inpatient medical facilities from 1999 to 2017 for persons aged 1 to 75. The donation rate was calculated by dividing SRTR deceased donor organ counts by CDC WONDER eligible death counts. Donation rates were age-standardized to the 2000 projected US population. We used logistic regression to quantify changes in donation rates over time.

*Results: While overall age-standardized donation rates have increased by 3% per year (p<0.001), racial/ethnic differences have persisted (Figure 1). As compared to Whites, donation rate among Black, Asian or Pacific Islanders, and American Indian or Alaska Native populations were less by 46%, 44%, and 75%, respectively (p<0.001). Hispanic/Latino were 7% less likely to donate than Non-Hispanic Latino populations (p<0.001) (Figure 2).

*Conclusions: Current evidence around deceased organ donation has insufficiently addressed population-level racial/ethnic differences. Addressing these differences likely requires a shift in research hypotheses and intervention design. Process evaluation, and implementation of evidence-based, multilevel interventions might decrease racial differences in donation rates.

Figure 1. Age-Standardized Donation Rates by Race from 1999 to 2017

Figure 2. Age-Standardized Donation Rates by Ethnicity from 1999 to 2017

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