Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/21245
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dc.contributor.authorShepherd, Leeen_UK
dc.contributor.authorO'Carroll, Ronanen_UK
dc.contributor.authorFerguson, Eamonnen_UK
dc.date.accessioned2014-12-01T23:17:10Z-
dc.date.available2014-12-01T23:17:10Z-
dc.date.issued2014-09-24en_UK
dc.identifier.other131en_UK
dc.identifier.urihttp://hdl.handle.net/1893/21245-
dc.description.abstractBackground: Policy decisions about opt-in and opt-out consent for organ donation are based on limited evidence. To fill this gap we investigated the difference between deceased and living organ donation rates in opt-in and opt-out consent systems across a 13 year period. We controlled for extensive covariates and estimated the causal effect of consent with instrumental variables analysis. Method: This panel study used secondary data analysis to compare organ donor and transplant rates in 48 countries that had either opt-in or opt-out consent. Organ donation data were obtained over a 13-year period between 2000 and 2012. The main outcome measures were the number of donors, number of transplants per organ and total number (deceased plus living) of kidneys and livers transplanted. The role of consent on donor and transplant rates was assessed using multilevel modeling and the causal effect estimated with instrumental variables analysis. Results: Deceased donor rates (per-million population) were higher in opt-out (M = 14.24) than opt-in consent countries (M = 9.98; Β = -4.27, 95% confidence interval (CI) = -8.08, -0.45, P = .029). However, the number of living donors was higher in opt-in (M = 9.36) than opt-out countries (M = 5.49; B = 3.86, 95% CI = 1.16, 6.56, P = .006). Importantly, the total number of kidneys transplanted (deceased plus living) was higher in opt-out (M = 28.32) than opt-in countries (M = 22.43; B = -5.89, 95% CI = -11.60, -0.17, P = .044). Similarly, the total number of livers transplanted was higher in opt-out (M = 11.26) than opt-in countries (M = 7.53; B = -3.73, 95% CI = -7.47, 0.01, P = .051). Instrumental variables analysis suggested that the effect of opt-in versus opt-out consent on the difference between deceased and living donor rates is causal. Conclusions: While the number of deceased donors is higher than the number of living donors, opt-out consent leads to a relative increase in the total number of livers and kidneys transplanted.en_UK
dc.language.isoenen_UK
dc.publisherBioMed Centralen_UK
dc.relationShepherd L, O'Carroll R & Ferguson E (2014) An international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: a panel study, BMC Medicine, 12, Art. No.: 131. https://doi.org/10.1186/s12916-014-0131-4.en_UK
dc.rights© 2014 Shepherd et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en_UK
dc.subjectOpt-in consenten_UK
dc.subjectOpt-out consenten_UK
dc.subjectDeceased organ donationen_UK
dc.subjectLiving organ donationen_UK
dc.titleAn international comparison of deceased and living organ donation/transplant rates in opt-in and opt-out systems: a panel studyen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1186/s12916-014-0131-4en_UK
dc.citation.jtitleBMC Medicineen_UK
dc.citation.issn1741-7015en_UK
dc.citation.volume12en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.author.emailronan.ocarroll@stir.ac.uken_UK
dc.contributor.affiliationPsychologyen_UK
dc.contributor.affiliationPsychologyen_UK
dc.contributor.affiliationUniversity of Nottinghamen_UK
dc.identifier.isi000342376400001en_UK
dc.identifier.scopusid2-s2.0-84910033171en_UK
dc.identifier.wtid612466en_UK
dc.contributor.orcid0000-0002-5130-291Xen_UK
dc.date.firstcompliantdepositdate2014-11-17en_UK
Appears in Collections:Psychology Journal Articles

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