Increasing registrations on the Australian Organ Donor Register

Many people are aware that Australia has an opt‐in system for recording organ donation decisions; and many are also aware that, historically, donation decisions were recorded on the driver's licence. What is not well known is that, in 2000, the Australian Organ Donor Register (AODR) was introduced as a register of consent (or objection), and that, between 2005 and 2012, the recording of donation decisions (except for South Australia) was transitioned from the driver's licence to registration on the national register, the AODR.1 Five years on, 53% of the people we surveyed in New South Wales (n = 802) were unaware that donation decisions were no longer recorded on the driver's licence,2 and less than a third of eligible Australians had registered their decision on the AODR.3 The implications of this are profound. Consent to donate by the next‐of‐kin in the intensive care unit is 90% when decisions are registered on the AODR, but only 44% when the decision is unknown.4

We have responded to the need to increase registration rates by developing5 an immediate registration opportunity, which combines the opportunity to discuss donation in a face to face interaction with the opportunity to register on the AODR immediately.2 Participants’ concerns, fears and questions about donation are prompted through a brief survey about organ donation beliefs, which facilitates discussion and allows misconceptions to be addressed. The participants are then asked if they would like to register on the AODR.

This initiative has been successful in increasing AODR registrations among the general public at a range of locations in NSW in 2017,2 and we had even higher success rates when we rolled this out in two NSW hospital‐based settings (Box). Integral to the success of the immediate registration opportunity is the consistent finding that the public and health care staff simultaneously hold positive beliefs and negative concerns about organ donation. Addressing the tension created by these dichotomous beliefs through face to face interaction, coupled with the ease and immediacy of on‐the‐spot registration, facilitates the registration decision. We believe that offering the immediate registration opportunity nationally in hospital‐based settings and in the community has the potential to increase registrations in the AODR dramatically.