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

David S. Goldberg, Scott D. Halpern, Peter P. Reese

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)496-505
Number of pages10
JournalCritical care medicine
Volume41
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

Keywords

  • brain-dead donors
  • consent rates
  • eligible death
  • organ consent
  • organ donation
  • organ procurement organization

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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