Transplantation is widely felt to be the best treatment for end stage kidney disease. Unfortunately, as the transplant wait list increases, the number of kidney transplants performed has plateaued. To increase the number of deceased donor organs, it is important to have as many registered organ donors as possible. Internationally, Spain leads the world in actual donation rate at 35.5 donors per million population while the US has a rate of 26 donors per million population. Understanding this difference between donation rates requires understanding health policy (opt in vs. opt out consent), social and cultural attitudes towards organ donation, and education on organ donation.
It might be expected that physicians would understand the benefit of organ donation and have a high registration rate. However, a 2009 survey revealed that only 53% of attending surgeons were willing to donate their organs. In a recent essay published in JAMA, Dr. Ellen D. Feld eloquently recounts her decades-long hesitancy to sign up as an organ donor due to personal experiences as a medical student. We surveyed our readers at eAJKD and found that out of 53 people who completed the poll, 89% are registered as an organ donor. Respondents included board certified nephrologists (40%), medical students/trainees (24%), and nurses, dialysis technicians, and social workers (36%). Ninety-five percent of nephrologists were registered as organ donors compared to 77% of trainees (fellows and residents) and 89% of affiliated health care workers.
Our results suggest that our respondents have a robust organ donor registration rate of 89%. This may be because health care workers in nephrology see first-hand how organ donation saves lives. However, it is also possible that registered organ donors were more likely to respond to this survey, thus over-representing registered donors among our readership. Regardless, there were individuals who were not registered as organ donors. Although not statistically significant, trainees had the lowest donor registration rate, a worrisome finding. Whether their reluctance stems from personal experiences similar to Dr. Feld, religious beliefs, or other reasons as simple as just not knowing how – or not having enough time – remains unknown.
We agree with Dr. Feld that more must be done to educate people on organ donation and understanding the reasons that deter individuals from registering. This includes educating health care workers and especially trainees who in turn can educate the general public. At eAJKD, we are committed to organ donation and would like to see 100% of our readership register as organ donors. In view of this commitment, we created a link to Donate Life America on our site to foster interest and education in organ donation. We hope that you, our readers, will register as organ donors and educate colleagues, friends, family, and patients on this life saving commitment.
Dr. Vinay Nair
eAJKD Advisory Board member