Problems in the identification of potential organ donors. Misconceptions and fallacies associated with donor cards

Abstract

A survey of organ procurement programs and district attorneys' offices was undertaken in all 50 states and the District of Columbia to determine to what extent organ donor cards were effective in obtaining organs for purposes of transplantation. Results of the survey revealed that all 50 states and the District of Columbia have adopted some form of the Uniform Anatomical Gift Act (UAGA), but in 47 states, even when a signed donor card is available, surgeons still require family approval for removal of organs despite the fact that the provisions of the UAGA do not require this. In addition, it was found that while 44 states have a provision on their permanent drivers' licenses for organ donation, no state requires drivers to indicate whether they want to donate organs. While there is little information on the number of persons who actually carry donor cards, four states indicated that between 1.7% and 8.5% of their drivers were designated as donors. In Colorado, however, it was reported that 60% of all drivers are designated as donors. Nevertheless, in all states it was determined that few actual donors were carrying donor cards at the time of their death. It must therefore be concluded that while donor cards are an excellent educational medium and certainly facilitate the activities of transplant coordination, they are not an effective means of substantially increasing the supply of organs for transplantation.

KIE: A survey of organ procurement programs and district attorneys' offices in every state and the District of Columbia was conducted to determine how effective donor cards were in obtaining organs for transplantation. The authors discovered that, although all jurisdictions have adopted some form of the Uniform Anatomical Gift Act and most have provisions for donor documentation on driver's licenses, there has been no substantial increase in the organ supply. Organ procurement appears to be hampered by current methods of card distribution, problems with maintaining referral networks, and uncertainties about the legal status of donor cards which have led hospitals to add a requirement for next-of-kin consent.