Legislation Has Small Effect on Live Donation

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TORONTO—Legislation aimed at increasing rates of live kidney donation has not substantially improved those rates, researchers concluded.

The finding is based on cross-sectional analyses using records of state legislatures in the 48 continental United States and living kidney donation rates from the United Network for Organ Sharing.

From January 1990 through December 2005, 28 states enacted legislation for living donors; five states enacted such legislation prior to 1999. In analyses that accounted for length of time legislation had been in effect, types of legislation enacted, and the incidence and prevalence of end-stage renal disease in each state, researchers found no change in related donation between 1997 and 2002, but a small increase in unrelated donation after legislation enactment compared with before enactment.

The researchers observed similar trends when they looked at the effect of federal initiatives on states that did not enact their own legislation. In addition, federal initiatives had no effect on donation rates for states enacting legislation, the in-vestigators reported at the 2008 American Transplant Congress.

“Our findings should be interpreted within the larger view of trends in living related donation in general: Rates overall plateaued after 2002, and this could be attributed to a variety of factors,” cautioned lead investigator L. Ebony Boulware, MD, MPH, of the Welch Center for Prevention, Epidemiology and Clinical Research in Baltimore. “It is possible that longer experience with legislation could provide more clarity on this.”

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