Increasing donation opportunities for vascularized composite allografts: An analysis of worldwide donor registries and procurement organization web content (VOLAR study)

There are 40 vascularized composite allotransplant programs across 5 continents served by 31 organ procurement organizations (or equivalent). The organizations' websites inform about organ and tissue donation. This research explored worldwide educational efforts on vascularized composite allograft (VCAG) donation via their corporate websites as well as options within donor registries and donor card systems to indicate a VCAG donation preference. Of these, 13 (41.9%) of 31 had VCAG content and 7 (22.6%) of 31 offered a mechanism for individuals to voice a preference about VCAG donation through an opt in donor registry or card or an opt out registry. In North America, the only donor registration/card system that facilitated VCAG donation is in Mexico. The resistance to consent for VACG donation is likely due to poor public education and the personal nature of face, hand, uterus, and penile allografts. Efforts to reduce this resistance can begin with the assistance of website content, registries, and donor cards.