Factors influencing the potential organ donation: a 6‐yr experience of the New Jersey Organ and Tissue Sharing Network

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Abstract
The demand for organ transplants in the United States is increasing by 16% every year. Unfortunately, organ donation figures are not increasing at the same rate. Factors that influence the process of organ donation in New Jersey were analyzed.Methods. A retrospective study in which the charts of actual and potential organ donors identified by the New Jersey Organ and Tissue Sharing Network (OTSN) between January 1990 and December 1995 were reviewed. Potential donors who were not identified by the OTNS or the United Network for Organ Sharing (UNOS) were not considered because no data relative to these cases were available. The conversion ratio (CR) between actual donor from potential donor was determined. A statistical analysis of the data was performed using multivariate regression logistic analysis.Results. Organ donation increased, both in the male and female population, by 14% over the last 6 yr. The 0–5‐yr age group experienced an increment in CR from 7.7 to 37.7% (p<0.001). All other age groups had a continuous improvement, but a statistically significant increase over time was not observed. The CR of all races increased over the 6‐yr study period. The Afro‐American population donated significantly less than the white population (32.1 vs. 59.9%) (p<0.001). The three transplant centers in New Jersey had a CR less than that seen in the non‐transplant centers (38.1 vs. 44.1%). The number of total donations (78.7 vs. 21.3%) was significantly greater in the non‐transplant centers (p<0.001). Moreover, the number of lost donors was higher at transplant centers (p<0.001). Over the 6‐yr period, the difference between donations coming from non‐urban (70.8%) versus urban areas (29.27%) was highly significant (p<0.001). Traumatic deaths were associated with a greater CR (55.3%) than all other causes of death. The CR for donors dying as a result of motor vehicle accidents (MVA) (p<0.001), penetrating trauma, and child abuse all increased. Level II trauma centers had a better CR (53.7%) than level I centers (48.4%) and non‐trauma centers (51.1%). The donation rate was similar for level II and non‐trauma centers (60%).Conclusions: The organ donation rate in New Jersey is not sufficient to meet the needs of organ recipients in New Jersey. Pediatric donations increased considerably, specifically from child abuse. MVA deaths are associated with the greatest CR. Urban areas have a worse CR than non‐urban areas, even if they are associated with transplant or trauma centers. We think that our study reveals different causes of organ donation failure in the OTNS pool of potential donor that accounted for 85% of the total pool in New Jersey in the period considered. This subject needs to be studied further, without losing time in futile consideration.Implementation of initiative and programs for health professional education is needed to improve the identification of potential donors by a standardized method in every New Jersey hospital and to reduce the medical examiner decline.Public education, such as commercial or public audit or a door‐to‐door campaign, should also be used to arouse public awarness of the importance of organ donation.