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Organ Procurement Organization Run Department of Motor Vehicle Registration and Drivers Licensing Offices Leads to Increased Organ Donor First Person Authorization Registrations

Dageforde, Leigh Anne MD, MPH1; Muren, William RN, MHA2; Chang, Su-Hsin PhD, SM3; Vachharajani, Neeta BS4; Brockmeier, Diane RN, MHA2; Yu, Jennifer MD4; Anderson, Blaire MD5; Shenoy, Surendra MD4; Lin, Yiing MD, PhD4; Khan, Adeel MD, MPH4; Wellen, Jason MD, MBA4; Chapman, William MD4; Doyle, Majella MD, MBA4

doi: 10.1097/TP.0000000000002842
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Background: More people who have personally consented to organ donation via First Person Authorization (FPA) registration prior to death become organ donors than those not personally consenting. The majority of registrations occur at state-specific department of motor vehicle (DMV) and licensing office where people register their vehicles and obtain drivers licenses.

Methods: One Organ Procurement Organization (OPO) ran three DMV offices and implemented an intervention: a donor-centric approach including employee education, office decoration with donation materials, and customer experience improvements. Data about registry enrollment was collected before and during the four-year OPO licensing office contract. A linear mixed model and interrupted time series analyses were performed to evaluate whether the intervention improved rates of registration.

Results: Preintervention registry enrollment rates per month were 10-50%. Having the offices run by an OPO was associated with more enrollments independent of the increasing trend of enrollment (p<0.001). Also, the DMV office with the lowest pre implementation registration rates had an immediate increase in enrollments after the intervention leading to higher registration rates (p<0.001).

Conclusions: A donor-centric OPO-managed DMV experience increases FPA registration especially at offices with low initial registration rates. However, even at the office with the highest percentage of FPA registrations, rates were only 65% at intervention conclusion. The transplant community should consider other opportunities for FPA registration.

1Department of Surgery, Division of Transplantation, Massachusetts General Hospital, Boston, Massachusetts

2Mid-America Transplant Services, Saint Louis, Missouri

3Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, Saint Louis, Missouri

4Department of Surgery, Division of Abdominal Organ Transplantation, Washington University in St. Louis School of Medicine, Saint Louis, Missouri

5Department of Surgery, Division of Transplant, Nebraska Medicine, Omaha, Nebraska

Funding: There was no funding received for this work.

Disclosure: The authors of this manuscript have do have conflicts of interest to disclose. Dr. MB Majella Doyle is a member of the Medical Advisory Board for Mid America Transplant and Dr. William Chapman is a member of the Mid America Transplant Foundation Board of Directors.

Corresponding Author: Leigh Anne Dageforde, MD, MPH, Massachusetts General Hospital, Department of Surgery, Division of Transplantation, 55 Fruit Street, White 511, Boston, MA 02114, ldageforde@mgh.harvard.edu

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