Incentivizing Authorization for Deceased Organ Donation with Organ Allocation Pr

[Clark]

http://onlinelibrary.wiley.com/doi/10.1111/ajt.13802/abstract?campaign=wolacceptedarticle

Original Article
Incentivizing Authorization for Deceased Organ Donation with Organ Allocation Priority: The First Five Years
      A. Stoler1,2,*, J.B. Kessler3, T. Ashkenazi4, A.E. Roth5 andJ. Lavee6,7
DOI: 10.1111/ajt.13802

American Journal of Transplantation
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Abstract
The allocation system of donor organs for transplantation may affect their scarcity. In 2008, Israel's Parliament passed the Organ Transplantation Law which grants priority on waiting lists for transplants to candidates who are first-degree relatives of deceased organ donors or who previously registered as organ donors themselves. Several public campaigns have advertised the existence of the law since November 2010. We evaluate the effect of the law using all deceased donation requests made in Israel during 1998-2015. We use a logistic regression to compare the authorization rates of the donors’ next-of-kin in the periods before (1998-2010) and after (2011-2015) the public was made aware of the law. The authorization rate for donation in the after period is substantially higher (55.1% vs. 45.0%, OR=1.43, p=0.0003), reaching an all-time-high rate of 60.2% in 2015. This increase is mainly due to an increase in the authorization rate of next-of kin of unregistered donors (51.1% vs. 42.2%). We also find that the likelihood for next-of-kin authorization to donation is approximately twice as high when the deceased is a registered donor, rather than unregistered (89.4% vs. 44.6%, OR=14.27, p<0.0001). We conclude that the priority law is associated with an increased authorization rate for organ donation.