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The impact of opt-out organ donation in Wales

The move to a soft opt-out organ donation system in Wales has not resulted in a step change in organ donation behaviour, the first rigorous examination of the data has found.

The study, published in BMJ Open, found that while the deceased organ donation rate has increased since the legislation was introduced, the increase is similar to that seen in other countries that have not introduced an opt-out scheme.

The consent rate for all modes of consent was 61.0 per cent (125/205) among the 205 potential organ donor cases included in the analysis. Under the previous opt-in system in Wales, consent rates for deceased organ donation ranged from a high of 53.6 per cent to a low of 48.5 per cent between 2013 and 2015.

Compared with the three years before the switch, there was a significant difference in Welsh consent rates under the opt-out system. However, over the same time period, consent rates in the rest of the United Kingdom also increased significantly from 58.6 per cent (5256/8969) to 63.1 per cent (2913/4614).

While organ donation registration increased from 34 to 38 per cent, the number of deceased donors did not increase (101 before compared with 104 after). Six per cent registered to opt-out.

Although there was general support for the soft opt-out system, decisions were not consistently supported by family members in death.

The authors say the success of the soft opt-out system is dependent on family members supporting their relative’s donation decision made in life. They say consent rates would have been higher if family members had consistently supported their relative’s opt-in decision, although this would apply to both opt-in and opt-out systems.


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