title: Incentivizing Authorization for Deceased Organ Donation With Organ Allocation Priority: The First 5 Years.
abstract: The allocation system of donor organs for transplantation may affect their scarcity. In 2008, Israel's Parliament passed the Organ Transplantation Law, which grants priority on waiting lists for transplants to candidates who are first-degree relatives of deceased organ donors or who previously registered as organ donors themselves. Several public campaigns have advertised the existence of the law since November 2010. We evaluated the effect of the law using all deceased donation requests made in Israel during the period 1998-2015. We use logistic regression to compare the authorization rates of the donors' next of kin in the periods before (1998-2010) and after (2011-2015) the public was made aware of the law. The authorization rate for donation in the period after awareness was substantially higher (55.1% vs. 45.0%, odds ratio [OR] 1.43, p = 0.0003) and reached an all-time high rate of 60.2% in 2015. This increase was mainly due to an increase in the authorization rate of next of kin of unregistered donors (51.1% vs. 42.2%). We also found that the likelihood of next-of-kin authorization for donation was approximately twice as high when the deceased relative was a registered donor rather than unregistered (89.4% vs. 44.6%, OR 14.27, p < 0.0001). We concluded that the priority law is associated with an increased authorization rate for organ donation.
authors.affiliation: Department of Economics, DePaul University, Chicago, IL.|Coherent Economics, Highland Park, IL.
authors.forename: A
authors.initials: A
authors.lastname: Stoler
authors.affiliation: Department of Business Economics and Public Policy, The Wharton School at the University of Pennsylvania, Philadelphia, PA.
authors.forename: J B
authors.initials: JB
authors.lastname: Kessler
authors.affiliation: Israel National Transplant Center, State Ministry of Health, Tel-Aviv, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Ashkenazi
authors.affiliation: Department of Economics, Stanford University, Stanford, CA.
authors.forename: A E
authors.initials: AE
authors.lastname: Roth
authors.affiliation: Heart Transplantation Unit, Department of Cardiac Surgery, Leviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Lavee
mesh_terms: D001926:Brain Death / Q000331:legislation & jurisprudence*; D005190:Family; D006284:Health Plan Implementation; D006801:Humans; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data / Q000639:trends; D014850:Waiting Lists
keywords: donors and donation: deceased; donors and donation: incentives; ethics and public policy; law/legislation; organ procurement; organ transplantation in general