• Sean S Lee, Michael W Sielski, and Kevin P Charpentier.
• Warren Alpert Medical School, Brown University, Providence, RI.
• J. Am. Coll. Surg. 2021 Feb 1; 232 (2): 187-194.e5.

BackgroundWe studied the contribution of the economic environment to an individual's decision to donate an organ by examining the relationship between the unemployment rate and the living donation rate.Study DesignWe obtained living organ donation data from the Organ Procurement and Transplant Network (OPTN) containing 134,138 organ donation events from 1990 through 2016. We obtained monthly unemployment rates from the Bureau of Labor Statistics (BLS) from 1990 through 2016, and obtained quarterly real gross domestic product (real GDP) by state from the Bureau of Economic Analysis (BEA) from 2005 through 2016. We conducted graphical and statistical analysis with regression modeling using state and time fixed effects.ResultsDescriptive graphical plots suggest that unlike the unemployment rate, the donation rate is non-cyclical over time, implying little association between the two factors. This is conferred by a linear regression model using state and calendar month fixed effects, where we found no significant association between the unemployment and donation rates (95% CI [-0.004, 0.008], interpreted as the change in number of donations per 100,000 people associated with 1% change in the unemployment rate). We also did not find any significant association between the real GDP and the donation rates. Subgroup analysis by sex, race, and age also revealed no significant associations.ConclusionsThe unemployment rate and the real GDP do not appear to be associated with the living organ donation rate, suggesting that the economic environment may not play a major role in the decision to donate an organ.Copyright © 2020 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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