The association of state and national legislation with living kidney donation rates in the United States: A national study

Leigh Boulware, M. U. Troll, L. C. Plantinga, N. R. Powe

Research output: Contribution to journalArticle

Abstract

The effect of state legislation and federal policies supporting living donors on living kidney donation rates in the United States is unknown. We studied living kidney donation rates from 1988 to 2006, and we assessed changes in donation before and after the enactment of state legislation and the launch of federal initiatives supporting donors. During the study, 27 states enacted legislation. Among states enacting legislation, there was no statistically significant difference in the average rate of increase in overall living kidney donations after compared to before state legislation enactment (annual increase in donations per 1 000 000 population [95% confidence interval] 2.39 [1.94-2.84] compared to 1.68 [0.89-2.47] respectively, p > 0.05). Among states not enacting legislation, there was a statistically significantly greater annual increase in overall donation rates from 1997 to 2002 compared to before 1997 when federal initiatives commenced, but there was no growth in annual rates after 2002. State and federal legislation were associated with increases in living-unrelated donation. These findings suggest that although existing public policies were not associated with improvements in the majority of donations from living-related donors, they may have had a selective effect on barriers to living-unrelated kidney donation.

Original languageEnglish (US)
Pages (from-to)1451-1470
Number of pages20
JournalAmerican Journal of Transplantation
Volume8
Issue number7
DOIs
StatePublished - Jul 2008

Fingerprint

Legislation
Kidney
Living Donors
Public Policy
Tissue Donors
Confidence Intervals
Growth
Population

Keywords

  • End-stage renal disease
  • Legislation
  • Living kidney donation
  • Willingness to donate

ASJC Scopus subject areas

  • Immunology

Cite this

The association of state and national legislation with living kidney donation rates in the United States : A national study. / Boulware, Leigh; Troll, M. U.; Plantinga, L. C.; Powe, N. R.

In: American Journal of Transplantation, Vol. 8, No. 7, 07.2008, p. 1451-1470.

Research output: Contribution to journalArticle

@article{5ee9be599ebf431aa999ff2b6cddf385,
title = "The association of state and national legislation with living kidney donation rates in the United States: A national study",
abstract = "The effect of state legislation and federal policies supporting living donors on living kidney donation rates in the United States is unknown. We studied living kidney donation rates from 1988 to 2006, and we assessed changes in donation before and after the enactment of state legislation and the launch of federal initiatives supporting donors. During the study, 27 states enacted legislation. Among states enacting legislation, there was no statistically significant difference in the average rate of increase in overall living kidney donations after compared to before state legislation enactment (annual increase in donations per 1 000 000 population [95{\%} confidence interval] 2.39 [1.94-2.84] compared to 1.68 [0.89-2.47] respectively, p > 0.05). Among states not enacting legislation, there was a statistically significantly greater annual increase in overall donation rates from 1997 to 2002 compared to before 1997 when federal initiatives commenced, but there was no growth in annual rates after 2002. State and federal legislation were associated with increases in living-unrelated donation. These findings suggest that although existing public policies were not associated with improvements in the majority of donations from living-related donors, they may have had a selective effect on barriers to living-unrelated kidney donation.",
keywords = "End-stage renal disease, Legislation, Living kidney donation, Willingness to donate",
author = "Leigh Boulware and Troll, {M. U.} and Plantinga, {L. C.} and Powe, {N. R.}",
year = "2008",
month = "7",
doi = "10.1111/j.1600-6143.2008.02266.x",
language = "English (US)",
volume = "8",
pages = "1451--1470",
journal = "American Journal of Transplantation",
issn = "1600-6135",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - The association of state and national legislation with living kidney donation rates in the United States

T2 - A national study

AU - Boulware, Leigh

AU - Troll, M. U.

AU - Plantinga, L. C.

AU - Powe, N. R.

PY - 2008/7

Y1 - 2008/7

N2 - The effect of state legislation and federal policies supporting living donors on living kidney donation rates in the United States is unknown. We studied living kidney donation rates from 1988 to 2006, and we assessed changes in donation before and after the enactment of state legislation and the launch of federal initiatives supporting donors. During the study, 27 states enacted legislation. Among states enacting legislation, there was no statistically significant difference in the average rate of increase in overall living kidney donations after compared to before state legislation enactment (annual increase in donations per 1 000 000 population [95% confidence interval] 2.39 [1.94-2.84] compared to 1.68 [0.89-2.47] respectively, p > 0.05). Among states not enacting legislation, there was a statistically significantly greater annual increase in overall donation rates from 1997 to 2002 compared to before 1997 when federal initiatives commenced, but there was no growth in annual rates after 2002. State and federal legislation were associated with increases in living-unrelated donation. These findings suggest that although existing public policies were not associated with improvements in the majority of donations from living-related donors, they may have had a selective effect on barriers to living-unrelated kidney donation.

AB - The effect of state legislation and federal policies supporting living donors on living kidney donation rates in the United States is unknown. We studied living kidney donation rates from 1988 to 2006, and we assessed changes in donation before and after the enactment of state legislation and the launch of federal initiatives supporting donors. During the study, 27 states enacted legislation. Among states enacting legislation, there was no statistically significant difference in the average rate of increase in overall living kidney donations after compared to before state legislation enactment (annual increase in donations per 1 000 000 population [95% confidence interval] 2.39 [1.94-2.84] compared to 1.68 [0.89-2.47] respectively, p > 0.05). Among states not enacting legislation, there was a statistically significantly greater annual increase in overall donation rates from 1997 to 2002 compared to before 1997 when federal initiatives commenced, but there was no growth in annual rates after 2002. State and federal legislation were associated with increases in living-unrelated donation. These findings suggest that although existing public policies were not associated with improvements in the majority of donations from living-related donors, they may have had a selective effect on barriers to living-unrelated kidney donation.

KW - End-stage renal disease

KW - Legislation

KW - Living kidney donation

KW - Willingness to donate

UR - http://www.scopus.com/inward/record.url?scp=47249096598&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=47249096598&partnerID=8YFLogxK

U2 - 10.1111/j.1600-6143.2008.02266.x

DO - 10.1111/j.1600-6143.2008.02266.x

M3 - Article

C2 - 18510639

AN - SCOPUS:47249096598

VL - 8

SP - 1451

EP - 1470

JO - American Journal of Transplantation

JF - American Journal of Transplantation

SN - 1600-6135

IS - 7

ER -