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Should We Promote Organ Donor Registries When So Few Registrants Will End Up Being Donors?

Department of Health Policy and Management, Emory University, Atlanta, GA, david.howard{at}emory.edu

Margaret M. Byrne, PhD

Department of Epidemiology and Public Health, University of Miami, Miami, FL

Background . A major obstacle facing efforts to register organ donors is that the likelihood that any given registrant will die in such a way as to render his or her organs suitable for donation is extremely low. Such policies make sense only if the resources used to sign up an additional donor are proportional to the expected benefits. Methods . Using data on historical donation patterns, estimates of the potential donor supply, and an estimate of the monetary value of an organ donor, the authors calculate the average value to society of a registrant as a function of age at registration. Result . Under a "first-person consent" regime, the value of a registrant ages 18 to 34 years is $1900. The value of registering individuals who have not already registered is even higher because these persons are more likely to become donors. If donor families have the right of refusal, the value of a registrant is substantially less, around $840. Conclusion . Given that most donor registries are fairly limited operations, piggybacking on drivers' license registration and renewal administration, results suggest that registries are cost-effective. Of course, a complete analysis awaits concrete data on the costs of operating registries and attracting new registrants.

Key Words: Key words: tissue and organ procurement • registries • costs and cost analysis • organ transplantation. (Med Decis Making 2007;27:243—249)

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