Perceptions of the Organ Allocation System
Boulware LE, Troll MU, Wang N-Y, Powe NR
Am J of Transplant. 2007;7:1778-1787

The authors conducted a national telephone survey of 845 participants and asked them about their understanding of organ allocation in the United States, their perception of the fairness of the allocation system, and their willingness to donate. The majority or respondents reported that they did not understand the allocation system very well, and that they perceived it as being unfair, or were unsure of its fairness. Individuals who perceived the system as unfair or who were unsure were less willing to be organ donors than those who perceived the system as fair. There were important variations among individuals of different ethnic groups and income levels, with minorities and lower-income individuals less likely to perceive the system as being fair and less likely to donate.

Abstract

Although this was a somewhat difficult article to read and digest in detail, it is a very important study for the transplant community. The nationwide consent rate for organ donation remains approximately 50%. Although there have been recent increases in the number of deceased donors, the number of individuals on the waiting list for solid organs continues to increase, as does the number of individuals who die on the waiting list. The association between the perception of fairness of the system and the willingness to donate is of critical importance. It is incumbent on all of us in the field, and especially those who design the allocation systems, to ensure that public understanding and perception of fairness of the system are maximized, and this involves the design of allocation systems that are transparently fair for everyone.