US policies to boost organ donations don’t work: study

Government policies aimed at increasing the number of organ donors in the United States have fallen flat, and bolder steps are needed to fix an urgent public health crisis, researchers said Monday.

Each year, about 120,000 people are on the waiting list for an organ transplant, but fewer than 30,000 operations are performed and about 10,000 people either die or become too sick to receive a donation while they wait.

It is forbidden in the United States to pay people cash for their organs, but state programs aim to boost incentive by offering public education, allowing tax benefits in exchange for donations, making it easier for people to donate by not requiring the consent of their family at the time of donation, and offering paid leave to cover a person’s time off work needed in case of a living donation, such as a kidney.

The research in the Journal of the American Medical Association (JAMA) Internal Medicine examined a series of state-led programs since the 1980s aimed at increasing the number of organ donations, amid a critical shortage in the organ supply.

From 1988 to 2010, the number of states passing at last one donation-related policy increased from seven to 50, the study found.

The problem is, the programs have not worked.

“First-person consent laws, donor registries, public education, paid leave and tax incentives were not associated with either donation rates or numbers of transplants,” said the study.

“Only revenue policies, where individuals can contribute to a protected state fund for donation promotion activities, were associated with a 5.3 percent increase in the number of transplants, which was equivalent to, on average, 15 additional transplants per state per year,” it said.

The success of this type of incentive was small and varied from state to state, and researchers said more study is needed to determine what else would work better.

The study was led by Erika Martin of the Nelson A. Rockefeller Institute of Government and Rockefeller College of Public Affairs and Policy, University at Albany, State University of New York.

In an accompanying commentary, Sally Satel of the Yale University School of Medicine urged bolder steps in the future.

“We believe it is time for disruptive innovation. By this concept, we mean compensating donors, not simply seeking to soften the financial ramification of donation,” she wrote.

“It is time to test incentives, to reward people who are willing to save the life of a stranger through donation.”