Changes in consent rate, expressed deceased donation decision-making and family interactions in Israel - a national retrospective cohort study.

This study aimed to compare the consent rate for deceased organ donation in Israel over two time periods, namely 2004-2009 (2004/9) and 2016-July 2020 (2016/20). Donor and family data were collected from the Israel National Transplantation Center Registry and included donor characteristics, reasons for family consent and refusal and a subjective assessment of donor coordinator-family interactions. The consent rate increased from 41.6% over the period 2004/9 to 61.8% for the period 2016/20 (p < 0.0001). A significant increase in the proportion of Jewish donors was noted (49.8% in 2004/9 vs. 67.5% in 2016/20, P < 0.0001) while no increase in the consent rate for the Muslim population was noted. Religious objections as a reason for refusal decreased significantly (37.6% vs. 27.3%; P = 0.02) while the proportion of families citing donating as the "right thing to do" increased significantly (7% vs. 26.6%; P < 0.0001). Finally, a significant increase in the proportion of very positive DC - family interactions (59% to 78.3%, P < 0.0001) was noted. In conclusion, the increased consent rate in 2016/20 was associated with changes in expressed decision-making and donor coordinator- donor family interactions. Additional interventions tailored to all different populations groups need to be developed and further investigated.