By 2026, Deceased Kidney Donations Could Jump By 61%. Here's How.


Although nearly half of US adults are registered organ donors, transplant waitlists remain long. New research outlines how to accelerate improvement and offers key considerations for payers and regulators.

Bruce Hamory, MD, Minoo Javanmardian, PhD, and Dan Shellenbarger

6 min read

Editor's Note: The following is a summary of a few findings from a September 2020 study Oliver Wyman conducted in partnership with Hogan Lovells and its client, a work group of Organ Procurement Organizations (OPOs). This research assesses deceased donor organ donation in the US. Read the full research here: Increasing Deceased Donor Organ Donation and Transplantation.

The purposeful acceleration of today's annual improvement rate in deceased donor kidney recovery and transplantation is a realistic goal, yet one that demands a comprehensive plan with many touchpoints collaborating and communicating towards a singular goal. This can be through sustained OPO performance improvement already underway and the implementation of new system-wide initiatives to ultimately increase the acceptance of more kidneys recovered and offered by OPOs. Achieving these performance gains could increase the number of deceased donor kidneys transplanted by 61 percent come 2026 (from 17,583 as of 2020 to 28,310 in 2026). The accumulative significance of these improvements above 2020 levels (and in addition to the current annual growth rate) would result in an additional 41,851 kidney transplants over six years. 

Here are just a few highlights from our research regarding some of our recommendations for industry change:

Eight Key Research Findings

1. OPOs Must Continue to Improve

OPOs must continue increasing the number of deceased donor recoveries which have driven the current growth in kidney transplants. This is in order to maintain significant growth in kidneys transplanted per year. 

2. So Must Organ Utilization by Transplant Programs

Increased donor and organ recovery will only result in more patients transplanted if it is paired with increases in the utilization of available organs by transplant centers.

3. Stakeholders Must Collaborate Effectively

Organ recovery must happen in a compressed timeframe, requiring stakeholder groups to work together effectively to maximize successful organ transplant outcomes.

4. A Comprehensive, Coordinated Approach is Necessary

Increasing donor authorization rates and encouraging the recovery of more donors across older age bands and more donation after circulatory death (DCD) donors could increase kidney donation by 1,774 kidneys per year.

5. Families are Key Decision Drivers

Family intervention plays a key role — even when the decedent had previously registered as a donor — because the family can decide to terminate life support (turn off the respirator) before organ retrieval can occur.

6. There are Opportunities for Improvement

Through our modeling, we found that 2.8 million total deaths in 2019, of which an estimated 770,000 (27 percent) occurred in hospitals. 7,000 of these in-hospital deaths could have met the basic criteria for the evaluation of potential organ donation.

7. Expanded Definitions of "Acceptable Donors" May Lead to More Transplants

Improving authorization rates and recovery of organs from older and/or DCD donors could result in more than 900 incremental donors per year.

8. Organ Acceptance Goes Beyond the Clinical 

The decision by a transplant center to accept an organ for transplant and then to implant it into a recipient is primarily a clinical one, but can be heavily influenced by operational, regulatory, and financial considerations, each of which warrants closer consideration. 

Greater Implications

The US has one of the highest rates of deceased donation in the world. But more needs to be done. If opportunities for improvement are leveraged, this could likely further increase donation authorization and lead to additional donors and kidney transplants.

For more information and more findings, read the full report: Increasing Deceased Donor Organ Donation and Transplantation.