Researchers: Amir Elalouf¹, Joseph S. Pliskin²

Background: There is a gap between the number of patients awaiting deceased-donor organ transplants and the rate at which organs become available. Though organs for transplantation are a community resource, and the organ supply depends on public willingness to donate, current allocation schemes do not explicitly incorporate public preferences.

Objectives: This paper seeks to provide insights about the Israeli public’s preferences regarding criteria for organ allocation, and to determine whether these preferences are in line with current allocation policies.

Method: A market research company administered a telephone survey to 604 adult participants representing the Jewish-Israeli public (age range: 18–95; 50% male). The questionnaire comprised 39 questions addressing participants’ knowledge, preferences regarding organ allocation, and willingness to donate.

Findings: Prognosis (51.3%) and waiting time (21%) were marked as most important criteria in prioritizing waitlist candidates, while donor status (donor card holders) was ranked as least significant (43%). Most participants expressed willingness to donate the organs of a deceased relative; they indicated that their willingness will grow if allocation policies took their preferences into account. Contrary to other surveys results (in the UK, the US, Australia), Israelis did not assign high importance to candidate’s age (24% ranked it as the least important factor). Interestingly, in some cases, participants’ declared preferences regarding the importance of various allocation criteria diverged from their actual choices in hypothetical scenarios.
Conclusions: The findings indicate that Israel’s citizens are willing to participate in decisions about organ allocation. They have a fluid concept of what they deem to be just, and generally, their preferences are compatible with current policy.

Conclusions: The findings indicate that Israel’s citizens are willing to participate in decisions about organ allocation. They have a fluid concept of what they deem to be just, and generally, their preferences are compatible with current policy.

Recommendations: A more balanced allocation system depends on a broad and inclusive deliberation system. Inclusion of different stakeholders might yield a system that is efficient, fair and more representative. Additional study researches the preferences of healthcare clinicians.

Research end date: 11/2019