Horizons in TransplantationOrgan donationStability of Organ Donor Designations on Driver's Licenses

•The stability of consent to donate organs has not been extensively studied.•This study examined the stability of donation consent over time among patients of a large urban safety-net medical system, using the last 2 forms of identification scanned into their electronic medical records.•Ten percent of patients had differing organ donor designations between their 2 documents.•Six percent of patients who initially had a donor designation on the first document did not have a donor designation on the second document.•Additional work identifying the reason for changes in donation consent is needed.

BackgroundLittle is known about the stability of decisions that people make to be organ donors. We sought to determine the rate of stability of organ donor designations on driver's licenses.MethodsWith the use of a cross-sectional study design, we reviewed the health records of 2500 randomly selected primary-care patients at a large urban safety-net medical system to obtain their demographic and medical characteristics. We also examined the two most recent unique driver's licenses, state identification cards, or learner's permits that were scanned into electronic health records as part of the patient registration process. We obtained organ donor designations from these documents for each patient.ResultsOf all patients, 1174 (47%) had two driver's licenses, identification cards, or permits in their electronic medical records. The two documents were issued an average of 3.5 years apart. Overall, 114 (10%) patients had differing organ donor designations on their two documents. Among the 502 patients who were designated as organ donors on the first document, 32 (6%) were not designated as organ donors on the second document. Among the 672 patients who were not designated as organ donors on the first document, 82 (12%) were designated as organ donors on the second document. There was little relationship between stability of organ donor designations and patient demographic and medical characteristics.ConclusionsAbout 1 of every 10 patients changed their organ donor designation, but stability was not associated with any demographic or medical factors. Further work is needed to understand why individuals change their organ donor designation.