Yorick J. de Groot, MD; Hester F. Lingsma, PhD; Erwin J.O. Kompanje, PhD
Potential Conflicts of Interest: None disclosed.
de Groot YJ, Lingsma HF, Kompanje EJ. Rates of Kidney Transplantation in Nations With Presumed Consent. Ann Intern Med. 2011;154:778. doi: 10.7326/0003-4819-154-11-201106070-00013
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Published: Ann Intern Med. 2011;154(11):778.
TO THE EDITOR:
We read with great interest Horvat and colleagues' article (1) on the rates of kidney transplantation in nations with presumed consent. Although we applaud the initiative to investigate this much-debated and delicate topic, we have some concerns about the methodology of the study, the practical implementation of the consent legislation, and the authors' conclusions.
Horvat and colleagues report that crude rates of deceased donor kidney transplantation are higher in countries with presumed consent, whereas rates of living donor kidney transplantation are higher in nations with explicit consent. However, these compared groups have different characteristics, such as their mean population and their gross domestic product. The authors attempt to account for these differences by making comparisons stratified for each of these characteristics.
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