Evolution of Deceased Organ Donation Activity Versus Efficiency Over a 15-year Period: An International Comparison

Council of Europe European Committee on Organ Transplantation (CD-P-TO)

Research output: Contribution to journalArticlepeer-review


BACKGROUND: The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs.

METHODS: This is a retrospective analysis of 2001 to 2015 deceased organ donation and mortality registry data. Included are 27 Council of Europe countries, as well as the United States. A donor conversion index (DCI) was calculated for assessing donation program efficiency over time and in international comparisons.

RESULTS: According to the DCI and of the countries included in the study, Spain, France, and the United States had the most efficient donation programs in 2015. Even though mortality from the selected causes decreased in most countries during the study period, differences in international comparisons persist. This indicates that the potential for deceased organ donation and its conversion into actual donation is far from being similar internationally.

CONCLUSIONS: Compared with the DR, the DCI takes into account the potential for deceased organ donation, and therefore is a more accurate metric of performance. National donation programs could optimize performance by identifying the areas where most potential is lost, and by implementing measures to tackle these issues.

Original languageEnglish
Pages (from-to)1768-1778
Number of pages11
Issue number10
Publication statusPublished - Oct 2018


  • Cause of Death
  • Cross-Cultural Comparison
  • Efficiency, Organizational
  • Europe/epidemiology
  • Humans
  • Organ Transplantation/statistics & numerical data
  • Registries/statistics & numerical data
  • Retrospective Studies
  • Tissue Donors/statistics & numerical data
  • Tissue and Organ Procurement/organization & administration
  • United States/epidemiology


Dive into the research topics of 'Evolution of Deceased Organ Donation Activity Versus Efficiency Over a 15-year Period: An International Comparison'. Together they form a unique fingerprint.

Cite this