Analysis of contributors to possible organ donor discards in Chile

Abstract

Organ transplantation is the best therapeutic option for several end-stage diseases. Nonetheless, there is an organ shortage due to lack of organ donation. Chile’s low organ donation rate of 7.8 donors per million population is due to high familial refusal to donation, lack of possible organ donor referral, but most importantly, high number of discarded possible organ donors. To understand the factors that contribute to discarding possible donors, we used multi-level multivariate logistic regressions using individual-level and hospital-level explanatory variables. The statistically significant variance among hospitals and Local Procurement Coordinations (LPC) explains whether a patient is being discarded as well as the patient's gender, the population-level of poverty, rurality, and years of schooling where the hospitals are located. We propose standardizing the procurement process and implementing monitoring and evaluation technology tools to reduce variation across hospitals and LPCs, and thus, increase the number of effective organ donors in Chile.