Conference Report: Increasing Organ Donation and Transplantation: The Challenge of Evaluation. INTRODUCTION


The purpose of the National Organ and Tissue Initiative of the Department of Health and Human Services is to build on the experiences of public, private, and volunteer initiatives for increasing the number of donor organs available to the growing list of Americans awaiting transplants. In doing so, HHS seeks to learn what program interventions work in improving organ donation.

The main goal of this conference, "Increasing Donation and Transplantation: The Challenge of Evaluation," was to identify successful and promising approaches to increasing organ donation (and therefore, transplantation) that have been, or can be, evaluated. The conference presentations and discussions helped to identify measures and evaluation methods that can be used to determine the effectiveness of various approaches to increasing donation. Much of the content of the presentations of the conference dealt with descriptions of the various program interventions. Given the emphasis of this conference on the challenges of evaluation, this summary report draws on the evaluative aspects of the presentations (including hard copies of presentations and supporting material provided by the presenters), audience discussion, and expert panel comments. This report is to serve as a resource for future organ donation activities by highlighting the promising approaches for increasing donation and how they can be evaluated.

Margaret Hamburg, M.D., the HHS Assistant Secretary for Planning and Evaluation, opened the conference by discussing the initiative’s goal of increasing organ donation by 20% in two years, and regulatory changes underway to facilitate this goal. Kevin Thurm, J.D., HHS Deputy Secretary, opened the second day of the conference by reporting on the need for increased organ donations in the U.S. and outlining specific steps the Department is taking to ensure that organ donation goals are met. He described how proposed changes to the federal regulations have been developed to build a more systematic approach to national organ and tissue donation issues.

The abstracts presented at this conference were solicited by the HHS Office of the Assistant Secretary for Planning and Evaluation (OASPE) and describe evaluations of efforts to increase donation. The evaluations are in many stages, including those that are completed, ongoing, and planned for current activities. The presentations focused on a range of approaches, such as those to increase consent, improve the efficiency of the donation system, promote behavioral change, and reach specific target populations. The presentations were organized into five general program types according to the relative proximity of the specified activity and related evaluation to a measurable change in the organ donation rate.