*Purpose: Chronic organ shortages result in unnecessary waitlist deaths, making improvements in donation an urgent problem in transplantation. Historically, barriers to donation have been noted among non-white populations, and local organ shortages have been ascribed to a higher proportion of racial and ethnic minorities in the population. In the absence of objective donation performance data, however, the validity of these claims is uncertain.

*Methods: United Network for Organ Sharing data on numbers of deceased donors between 1/1/13 and 12/31/17 were compared with Centers for Disease Control & Prevention records of all inpatient deaths from causes consistent with donation among persons aged <75 years over the same period. Dependent variables included donor/decedent race and ethnicity and donation service area (DSA) of event. DSA-level performance was defined on standard deviation above/below the mean for white patients.

*Results: In total, there were 46,201 donors among 438,908 deaths. The rate of donation per 1000 cause, age, and location-consistent (CALC) deaths varied greatly across DSAs (median 103.5, min 65.0, max 183.6). In analysis not including DSA, the rate of donation per 1000 CALC deaths was lower in Asian and African Americans populations than among whites (82.9 and 94.0 vs. 102.5, p < 0.001 for each comparison), but this was lower than that observed among Hispanics (130.9, p < 0.001). As the DSA-level donation rate among white decedents increased, non-white donation rates also increased (Figure 1, p < 0.001 for trend). White and non-white donation rates did not significantly differ within each stratum of DSA performance.

*Conclusions: Objective metrics show the strong potential for donation among minorities. Minority donation is equivalent to that observed among whites within a given level of DSA performance. Strategies to engage minority communities should be coupled with continued efforts to define and disseminate best practices for donation nationwide.

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