Interventions for increasing solid organ donor registration

Background A solution for increasing the number of available organs for transplantation is to encourage more individuals to register a commitment for deceased organ donation. However, the percentage of the population registered for organ donation remains low in many countries. Objectives To evaluate the benefits and harms of various interventions used to increase deceased organ donor registration. Search methods We searched the Cochrane Kidney and Transplant Register of Studies up to 11 August 2020 through contact with an Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register Search Portal and ClinicalTrials.gov. Selection criteria We included all randomised controlled trials (RCTs), cluster RCTs and quasi‐RCTs of interventions to promote deceased organ donor registration. We included studies if they measured self‐reported or verified donor registration, intention to donate, intention to register a decision or number of individuals signing donor cards as outcomes. Data collection and analysis Two authors independently assessed retrieved studies and extracted data from included studies. We assessed studies for risk of bias. We obtained summary estimates of effect using a random‐effects model and expressed results as risk ratios (RR) (95% confidence intervals; CI) for dichotomous outcomes and mean difference (MD; 95% CI) or standardised mean difference (SMD; 95% CI) for continuous outcomes. In multi‐arm trials, data were pooled to create single pair‐wise comparisons. Analyses were stratified by specific intervention setting where available. Main results Our search strategy identified 46 studies (47 primary articles, including one ) comprising 24 parallel RCTs, 19 cluster RCTs and 3 quasi‐RCTs. Sample sizes ranged from 138 to 1,085,292 (median = 514). A total of 16 studies measured registration behaviour, 27 measured intention to register/donate and three studies measured both registration behaviour and intention to register. Interventions were delivered in a variety of different settings: schools (14 studies), driver’s motor vehicle (DMV) centres (5), mail‐outs (4), primary care centres (3), workplaces (1), community settings (7) and general public (12). Interventions were highly varied in terms of their content and included strategies such as educational sessions and videos, leveraging peer l