title: Worldwide variability in deceased organ donation registries.
abstract: The variability in deceased organ donation registries worldwide has received little attention. We considered all operating registries, where individual wishes about organ donation were recorded in a computerized database. We included registries which recorded an individual's decision to be a donor (donor registry), and registries which only recorded an individual's objection (non-donor registry). We collected information on 15 characteristics including history, design, use and number of registrants for 27 registries (68%). Most registries are nationally operated and government-owned. Registrations in five nations expire and require renewal. Some registries provide the option to make specific organ selections in the donation decision. Just over half of donor registries provide legally binding authorization to donation. In all national donor registries, except one, the proportion of adults (15+) registered is modest (<40%). These proportions can be even lower when only affirmative decisions are considered. One nation provides priority status on the transplant waiting list as an incentive to affirmative registration, while another nation makes registering a donation decision mandatory to obtain a driver's license. Registered objections in non-donor registries are rare (<0.5%). The variation in organ donor registries worldwide necessitates public discourse and quality improvement initiatives, to identify and support leading practices in registry use.
authors.affiliation: Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Rosenblum
authors.forename: Alvin Ho-Ting
authors.initials: AH
authors.lastname: Li
authors.forename: Leo
authors.initials: L
authors.lastname: Roels
authors.forename: Bryan
authors.initials: B
authors.lastname: Stewart
authors.forename: Versha
authors.initials: V
authors.lastname: Prakash
authors.forename: Janice
authors.initials: J
authors.lastname: Beitel
authors.forename: Kimberly
authors.initials: K
authors.lastname: Young
authors.forename: Sam
authors.initials: S
authors.lastname: Shemie
authors.forename: Peter
authors.initials: P
authors.lastname: Nickerson
authors.forename: Amit X
authors.initials: AX
authors.lastname: Garg
mesh_terms: D000293:Adolescent; D000328:Adult; D001118:Argentina; D001208:Asia; D044362:Australasia; D005060:Europe; D006801:Humans; D009656:North America; D012042:Registries / Q000592:standards*; D014019:Tissue Donors; D009927:Tissue and Organ Procurement; D014850:Waiting Lists