Living kidney and liver donations and transplantations: an interrupted time series analysis spanning years, 1988-2020

In 2004, the Organ Donation and Recovery Improvement Act was signed into law to help assist and aid challenges that arise with organ donation and procurement. The objective of this study, that leveraged a national database from the Organ Procurement and Transplant Network, was to examine the association of the above policy on living kidney and liver donation and transplantation rates. The empirical strategy was an interrupted time series analysis that examined this policy's impact on the above rates pre-policy adoption, the passage of the policy, and post-policy adoption. Dependent variables were kidney and liver donation and transplantation rates, analyzed individually and collectively, with time, intervention, and post-policy intervention as independent variables. Donation rates of kidneys and livers were detected to decrease after the policy intervention, when analyzed individually. The same applied to transplantation rates of the above organs in this setting. The combined donation rate of the above organs showed a decrease in the years after the policy was effective which was similar to the combined transplantation rate, for years spanning 1988 through 2020. Implications include amplifying policy awareness, emphasizing outreach activities, further adjusting financial incentives to present-day inflation rates and standard of living costs, and magnifying the new kidney allocation system that has been effective since 2014.