Worldwide variability in deceased organ donation registries

Area of Science:

• Public Health
• Health Policy
• Transplantation Science

Background:

• Deceased organ donation registries exhibit considerable global variability.
• Understanding these differences is crucial for improving organ donation rates worldwide.
• Existing research has largely overlooked the characteristics of these registries.

Purpose of the Study:

• To analyze and compare the characteristics of operating deceased organ donation registries globally.
• To identify variations in registry design, function, and registrant data.
• To inform discussions on best practices for organ donor registry management.

Main Methods:

• A comprehensive review of 27 operating deceased organ donation registries (68% of global registries).
• Data collection on 15 key characteristics, including history, design, usage, and registrant numbers.
• Inclusion of both donor registries (recording consent) and non-donor registries (recording objections).

Main Results:

• Most registries are government-operated and national in scope.
• Registration renewal is required in five countries; some allow specific organ selection.
• Legally binding authorization is provided by just over half of donor registries, with modest registration rates (<40% of adults).
• Incentives like transplant waiting list priority and mandatory registration for driver's licenses exist.
• Registered objections in non-donor registries are infrequent (<0.5%).

Conclusions:

• The significant variation in organ donor registries necessitates global dialogue.
• Quality improvement initiatives are needed to identify and promote leading registry practices.
• Addressing registry variability can enhance organ donation and transplantation outcomes.