Department of Economics, Brigham Young University, Provo, UT, United States of America.
Department of Economics, University of Houston, Houston, TX, United States of America.
PLoS One. 2020 Nov 4;15(11):e0241672. doi: 10.1371/journal.pone.0241672. eCollection 2020.
Waiting times for organs in the United States are long and vary widely across regions. Donor registration can increase the number of potential donors, but its effect on the actual number of organ transplants depends upon several factors. First among these factors is that deceased donor organ donation requires both that death occur in a way making recovery possible and that authorization to recover organs is obtained. We estimate the potential donor death rate and donor authorization rate conditional on potential donor death by donor registration status for each state and for key demographic groups. With this information, we then develop a simple measure of the value of a new donor registration. This combined measure using information on donor authorization rates and potential death rates varies widely across states and groups, suggesting that focusing registration efforts on high-value groups and locations can significantly increase the overall number of donors. Targeting high-value states raises 26.7 percent more donors than a uniform, nationwide registration effort. Our estimates can also be used to assess alternative, but complementary, policies such as protocols to improve authorization rates for non-registered potential donors.
美国的器官等待时间较长，且在不同地区差异很大。供体登记可以增加潜在供体的数量，但它对实际器官移植数量的影响取决于几个因素。其中最重要的因素是，已故供体器官捐献需要死亡方式使得恢复成为可能，并且获得了恢复器官的授权。我们根据每个州和关键人口群体的供体登记状况，对潜在供体死亡时的潜在供体死亡率和供体授权率进行了估计。有了这些信息，我们就可以制定一个衡量新增供体登记价值的简单方法。这种综合衡量方法同时考虑了供体授权率和潜在死亡率，各州和群体之间差异很大，这表明将登记工作重点放在高价值群体和地区可以显著增加整体供体数量。与全国范围内的统一登记工作相比，针对高价值州的登记工作可以多增加 26.7%的供体。我们的估计也可用于评估其他但互补的政策，如提高非登记潜在供体授权率的方案。
