There is a huge gap between the number of people who need transplanted organs and the number that are donated. But most state-level policies that are intended to encourage organ donation had no impact, according to a study. The only policies that increased donation-minimally-were ones where people could contribute to a state fund that is used to promote organ donation.
How bad is the problem? In 2013, there were more than 121,000 people waiting for an organ compared to a little more than 14,000 people-either living or deceased-who donated almost 29,000 organs, according to the U.S. Department of Health and Human Services.
Because of this shortfall in the number of organs donated, every state has put in place policies such as tax incentives, donor registries, consent laws, dedicated revenue streams for donor recruitment, educational programs, and paid leave for donors.
The study examined data from the United Network for Organ Sharing and found that only the revenue policies worked and they increased the number of transplants by only a little over 5%. This is only 15 additional transplants per year per state. The other policies increased neither donation rates nor the number of transplants.
The study was published in JAMA Internal Medicine and was accompanied by an editorial that called for a complete overhaul of the American organ donation system. "We believe it is time for disruptive innovations," the editorial said. "By this we mean compensating donors, not simply seeking to soften the financial ramification of donation."
The editorial calls for incentives to reward people who are willing to save the life of a stranger through donation. Such incentives have been banned for fear that organs would be bought and sold or brokered between recipient and donor. Instead of direct payments, the editorial suggested rewards coming from third parties, such as tuition reimbursement, tax credits, or contributions to a retirement fund.