Impact of opt-in versus opt-out organ donation legislation on donation rates: A systematic review

Fifteen studies on organ donation policies were identified, with 13 high-quality studies included after rigorous screening. Based on these studies, opt-out consent systems show mixed outcomes across countries. Policy effectiveness varies significantly between nations. The COVID-19 pandemic substantially disrupted organ donation rates. Factors beyond legislation, such as public awareness, cultural attitudes, media campaigns, and health care infrastructure, also influence donation success.Practical impact:While presumed consent may increase deceased donor rates, it is not a universal solution. Effective organ donation strategies require a holistic approach involving public education, trust-building, and nuanced policy implementation tailored to specific national contexts.