D.C. and U.S. States Lead the World in Organ Donation Rates

JAMA Study Reports America’s “Opt-In” System is More Effective Than “Opt-Out” Approach in Other Countries

A recent analysis of organ donation rates around the world reports that four states, and the District of Columbia, lead the world in organ donation. D.C. donation rates rank an impressive 5th out of the study’s 90 national and international donation regions. Maryland and Virginia donation rates ranked 14th and 32nd respectively. The findings are published in a recent issue of the Journal of the American Medical Association (JAMA).

The report, which found that nine of the top 10 performers were U.S. states and D.C., looked at international donation rates per 10,000 deaths occurring in independent, legal jurisdictions around the world. Among its findings was that regions that have an “Opt-Out” program—where the government assumes under law that individuals are donors unless they formally register their decision not to participate— have donation rates that are 27 percent lower than the “Opt-In” regions, including the U.S.

“In the U.S., we allow individuals to make a legally binding decision to register to be an organ, eye and tissue donor and we encourage them to share their decision with their loved ones,” said Lori Brigham, President and Chief Executive Officer, Washington Regional Transplant Community. “Opt-In donation also allows families to choose organ donation if their loved one has not made a prior decision. This approach has proven to be effective in helping to save more lives through donation.” 

The JAMA article identifies the collaboration of U.S. Organ Procurement Organizations (OPOs), donor hospitals, state donor registries and 155 million Americans who have registered as donors as the reasons for the U.S.’s donation success, which is evidenced by a 30% increase in deceased organ donors—from 8,269 in 2013 to 10,722 in 2018.

This research identifies Spain as the only Opt-Out country ranked among the highest performing U.S. states. The heads of Spain’s program attribute their success not to Opt-Out but to their robust donation infrastructure and exceptional hospital-based, donor family support system that offsets Spain’s lack of a donor registry system.

The JAMA analysis supports national and local efforts to increase organ, eye and tissue donor registration via public education and partnerships with local DMVs and MVAs. Individuals can learn more about donation and can register to be a donor at BeADonor.org.