Person:

Anteby, Michel J.

Human cadavers are crucial to numerous aspects of health care, including initial and continuing training of medical doctors and advancement of medical research. Concerns have periodically been raised about the limited number of whole body donations. Little is known, however, about a unique form of donation, namely co-donations or instances when married individuals decide to register at the same time as their spouse as whole body donors. Our study aims to determine the extent of whole body co-donation and individual factors that might influence co-donation. Methods and Findings: We reviewed all records of registrants to the University of Hawaii Medical School's whole body donation program from 1967 through 2006 to identify married registrants. We then examined the 806 married individuals' characteristics to understand their decision to register alone or with their spouse. We found that married individuals who registered at the same time as their spouse accounted for 38.2 percent of married registrants. Sex differences provided an initial lens to understand co-donation. Wives were more likely to co-donate than to register alone (p = 0.002). Moreover, registrants' main occupational background had a significant effect on co-donations (p = 0.001). Married registrants (regardless of sex) in female-gendered occupations were more likely to co-donate than to donate alone (p = 0.014). Female-gendered occupations were defined as ones in which women represented more than 55 percent of the workforce (e.g., preschool teachers). Thus, variations in donors' occupational backgrounds explained co-donation above and beyond sex differences. Conclusions: Efforts to secure whole body donations have historically focused on individual donations regardless of donors' marital status. More attention needs to be paid, however, to co-donations since they represent a non-trivial number of total donations. Also, targeted outreach efforts to male and female members of female-gendered occupations might prove a successful way to increase donations through co-donations.

The number of human cadavers available for medical research and training, as well as organ transplantation, is limited. Researchers disagree about how to increase the number of whole-body bequeathals, citing a shortage of donations from the one group perceived as most likely to donate from attitudinal survey data—educated white males over 65. This focus on survey data, however, suffers from two main limitations: First, it reveals little about individuals' actual registration or donation behavior. Second, past studies' reliance on average survey measures may have concealed variation within the donor population. To address these shortcomings, we employ cluster analysis on all whole-body donors' data from the Universities of California at Davis, Irvine, Los Angeles, and San Francisco. Two donor groups emerge from the analyses: One is made of slightly younger, educated, married individuals, an overwhelming portion of whom are U.S. born and have U.S.–born parents, while the second includes mostly older, separated women with some college education, a relatively higher share of whom are foreign born and have foreign-born parents. Our results demonstrate the presence of additional donor groups within and beyond the group of educated and elderly white males previously assumed to be most likely to donate. More broadly, our results suggest how the intersectional nature of donors' demographics, in particular, gender and migration status, shapes the configuration of the donor pool, signaling new ways to possibly increase donations.