U.S. States Lead the World in Organ Donation

Just-Published Study in JAMA Reports That America’s “Opt-In” System is More Effective Than “Opt-Out” Approach Taken in Other Countries

LOS ANGELES--()--A just-released analysis of organ donation rates around the world reports that U.S. states lead the world in organ donation, with 43 of the top 50 performing international jurisdictions and nine of the top 10 performers being U.S. states. The findings are published in the current issue of the “Journal of the American Medical Association,” which posted today.

The report looks at international donation rates per 10,000 deaths occurring in independent, legal jurisdictions of countries and states around the world. Among its findings was that those regions that have an “Opt-OUT” program—where the government assumes under law that individuals are donors unless they formally register their decision not to participate—actually have donation rates that are 27 percent lower than the “Opt-IN” regions, including the United States.

“So called Opt-OUT countries do not actually rely on the legal default to take organs without family agreement, recognizing that without a donor’s prior affirmative decision to donate, no government wants to exercise this power with families at this tragic and challenging time,” says OneLegacy CEO Tom Mone who conducted the research in partnership with Alexandra Glazier, CEO of New England Donor Services in Boston. “The U.S. system allows each of us to register our decision to be a donor in a way that is a clear, affirmative and legally binding decision, much like a will or advanced directive that lets family members know their loved one’s decision to donate, that will be followed. Further, Opt-IN donation enables families to choose to donate when their loved one has not made a prior decision. Such a practice is deeply rooted in our society’s belief in individual rights and many laws and societal norms that prioritize individual autonomy.”

The JAMA article identifies the collaboration of U.S. Organ Procurement Organizations (OPOs), donor hospitals, state donor registries and 155 million Americans who have registered as donors as the reasons for the U.S.’s donation success, which is evidenced by a 30% increase in deceased organ donors—from 8,269 in 2013 to 10,722 in 2018.

This research identifies Spain as the only Opt-OUT country ranked among the highest performing U.S. states. The heads of Spain’s program attribute their success not to Opt-OUT but to their robust donation infrastructure and exceptional hospital-based, donor family support system that offsets Spain’s lack of a donor registry system.

Research also indicates that U.S. donation rates would actually be as much as 20% higher than Spain’s if U.S. transplant centers followed the Spanish and international practice of accepting and transplanting organs from donors between the ages of 70 and 85 and from donors with slightly higher risk for organ failure but with predicted benefits for recipients as compared to lingering on wait lists.

These donors and organs are currently assessed by OPOs but rejected by transplant programs due to what Mone calls “overly conservative and outdated transplant outcome measures imposed by Medicare and private insurers.” Mone says that OPOs receive and assess nearly 200,000 possible organ donors per year, with approximately only 8% qualifying today as clinically viable to donate. “Improvements in outcomes expectations could increase potential donors from 8% to 10% and lead to thousands more lifesaving transplants each year,” he says.

Among other significant findings of the research is that OneLegacy’s donors per 10,000 deaths ranks 17th out of the study’s 90 U.S. and international donation regions. This high performance is particularly revealing given that OneLegacy serves the greater Los Angeles / Southern California market, acknowledged to be one the most culturally, ethnically, linguistically and new immigrant diverse regions in the world.

This research supports national, state and local efforts to increase organ, eye and tissue donor registration efforts at DMVs, on social media, and supportive education in communities and schools. Individuals can learn more about organ donation and can register to be a donor at donatelifecalifornia.org.

About One Legacy

OneLegacy is a nonprofit organization dedicated to saving and healing lives through organ, eye and tissue donation in seven counties in Southern California: Los Angeles, Orange, Riverside, San Bernardino, Ventura, Santa Barbara and Kern. Serving more than 200 hospitals, 11 transplant centers and a diverse population of over 20 million, OneLegacy is the largest organ, eye and tissue recovery organization in the world, enabling 150,000 transplantations each year. For more information, visit onelegacy.org, like us on Facebook or follow us on Twitter.

Contacts

Ross Goldberg
818-597-8453, x-1
ross@kevinross.net

Release Summary

Just-published study in JAMA reports America’s “Opt-IN” system is more effective than “Opt-OUT” approach taken in other countries

Contacts

Ross Goldberg
818-597-8453, x-1
ross@kevinross.net