Increasing organ donation via changes in the default choice or allocation rule

Abstract

This research utilizes a laboratory experiment to evaluate the effectiveness of alternative public policies targeted at increasing the rate of deceased donor organ donation. The experiment includes treatments across different default choices and organ allocation rules inspired by the donor registration systems applied in different countries. Our results indicate that the opt-out with priority rule system generates the largest increase in organ donation relative to an opt-in only program. However, sizeable gains are achievable using either a priority rule or opt-out program separately, with the opt-out rule generating approximately 80% of the benefits achieved under a priority rule program.

Organ donation in the lab: Preferences and votes on the priority rule

“…We believe that this is an important insight: experiencing the donation dilemma in the lab has the potential to change people's attitudes in the field. We trust that the experimental results reported in Roth (2012, 2014b), Li et al (2013) and here, which strengthen support for the priority rule, may complement opinion poll data when public opinion is considered in the political decision-making process.…”

“…Our results confirm those obtained by Roth (2012, 2014b) and Li et al (2013). In our experiment, the average registration rate in the baseline treatment is 40 percent and the priority treatment increases the willingness to donate to 68 percent.…”

“…In lab experiments, a priority rule that gives preference to registered donors outperforms other allocation rules in increasing the willingness to donate organs (Kessler and Our first finding is that we successfully replicate previous experimental work Roth 2012, 2014b;Li et al 2013), using a non-US subject pool. We confirm that the priority system leads to more donor registrations than allocation systems without such a priority regulation.…”

“…With the health frame, participants can connect the experimental and the field setting more intuitively when asked for their opinion about the priority rule in the real world. In order to simplify the design, we again follow Li et al (2013) Following Kessler and Roth (2012), each of the 20 experimental rounds was played as follows. The round started with all subjects having an active A organ (brain) and two active B organs (kidneys).…”

Single lung transplantation has equivalent long term outcomes to bilateral lung transplantation in patients with pulmonary hypertension associated with advanced lung disease

“…A point-based system has been initiated in Israel that rewards potential donors by increasing the likelihood of receiving an organ themselves should they develop such need, and this policy has led to an increase in registered donors [15]. An "opt out" instead of the current "opt in" system (which theoretically will increase the number of registered donors) has been under examination in the US [16], and other measures to increase the donor pool include utilizing living donors for lobar lung transplants, increased use of donation after cardiac death donors, using donors with a significant history of smoking, using donors older than 55 years, and rehabilitation of marginal lungs with ex vivo perfusion [17][18][19][20][21][22]. Our study suggests that using SLT for patients with ALD accompanied by PH (a population that historically has been treated with BLT) can increase organ availability without compromising outcomes.…”