AHA was engaged by the Australian Government to undertake an investigation into the decline of living organ donations.

Australia has seen an ever-increasing number of patients with organ failure on waiting lists for clinical transplantation over past decades. Between 1991 and 2009, the annual number of kidney transplants performed increased by 65% (from 470 to 772 transplants).

However, in recent years, this upward trend has reversed. In 2011, 825 kidney transplants were performed in Australia, with live kidney donations comprising 31% of this total. This represents a reduction in both absolute numbers and proportion of total live donations from a peak in 2008.

Reasons for the decline in rates of living organ donation have been considered in a number of inquiries and reports; however, there was limited evidence to support the proposed causes.

This project represented an important step towards better understanding and responding to these factors.

The purpose of the project was to undertake an analysis and provide a report examining the factors contributing to the decline in living organ donors since 2008.

The factors explored included:

• Financial barriers to donation, noting the recent government announcement of a trial to reimburse donors for time and expenses relating to their donation
• Transplant capacity
• Reduction of living donors.

AHA consulted extensively with stakeholders in the transplantation sector, including patients who have received or who are waiting to receive a kidney transplant, and conducted a comparative literature review.