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. 2013 Feb;41(2):496-505.
doi: 10.1097/CCM.0b013e318271198c.

Deceased organ donation consent rates among racial and ethnic minorities and older potential donors

David S Goldberg  1 , Scott D Halpern, Peter P Reese
Affiliations

Deceased organ donation consent rates among racial and ethnic minorities and older potential donors

David S Goldberg et al. Crit Care Med. 2013 Feb.

Abstract

Objectives: We sought to assess consent rates for organ donation from potential brain-dead donors, and to identify factors associated with variation in consent for donation that could guide the development of targeted interventions to increase organ consent rates.

Design, setting, and subjects: We used data provided by the Organ Procurement and Transplantation Network to analyze the 35,823 organ procurement organization-reported eligible deaths (potential brain-dead donors ≤ 70 yr of age) from January 1, 2008, to October 31, 2011.

Measurements and main results: Excluding cases where donation authorization was based on prior patient documentation (e.g., donor registry), consent was obtained on 21,601 (68.9%), not obtained on 8,727 (27.8%), and not requested on 1,080 (3.4%) eligible deaths. There were substantial differences in consent rates among racial/ethnic groups (77.0% in whites, 67.5% in Hispanics, 54.9% in blacks, and 48.1% in Asians) and organ procurement organizations (median [interquartile range]: 72.4% [67.5-87.3]). In generalized estimating equation models, with whites and patients ages 18-39 yr as the respective reference groups, consent for donation was less likely to be obtained among Hispanics (odds ratio 0.54; 95% confidence interval 0.44-0.65), blacks (odds ratio 0.35; 95% confidence interval 0.31-0.39), Asians (odds ratio 0.31; 95% confidence interval 0.25-0.37), and eligible donors ages 55-64 (odds ratio 0.72; 95% confidence interval 0.67-0.77), and ≥ 65 yr (odds ratio 0.58; 95% confidence interval 0.52-0.64).

Conclusions: In presenting the first published analyses of consent rates among all eligible deaths, this study confirms smaller and regional studies that showed significant differences in consent rates between whites and racial/ethnic minorities (blacks, Hispanics, and Asians). The study also identifies considerable variation in consent rates between age groups and between organ procurement organizations. Critical care physicians are usually the front-line providers for potential brain-dead donors and their next-of-kin, and these data highlight the need for further research to identify the causes of variation in consent rates and mechanisms to increase rates where appropriate.

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Conflict of interest statement

The authors have not disclosed any potential conflicts of interest

Figures

Figure 1
Figure 1
Temporal trends in eligible deaths, consent rates, and organ donation in the United States
Figure 2
Figure 2
Distributions of donation consent rates across UNOS regions, by race/ethnicity category
Figure 3
Figure 3
Distributions of donation consent rates across UNOS regions, by age category
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