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Only 1\u20132% of deaths are eligible as donors with a fraction of the deceased donating organs. The form of consent to donation may affect the organs available. Forms of consent include: opt\u2010in, mandated choice, opt\u2010out, and organ conscription. Opt\u2010in and opt\u2010out are commonly practiced. A systematic review was conducted to determine the effect of opt\u2010in versus opt\u2010out consent on the deceased donation rate (DDR) and deceased transplantation rate (DTR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Literature searches of PubMed and EMBASE between 2006 and 2016 were performed. Research studies were selected based on certain inclusion criteria which include USA, UK, and Spain; compare opt\u2010in versus opt\u2010out; primary data analysis; and reported DDR or DTR. Modeled effect on US transplant activity was conducted using public data from Organ Procurement and Transplantation Network and Centers for Disease Control WONDER from 2006 to 2015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2400 studies were screened and six studies were included. Four studies reported opt\u2010out consent increases DDR by 21\u201376% over 5\u201314 years. These studies compared 13\u201325 opt\u2010out countries versus 9\u201323 opt\u2010in countries. Three studies reported opt\u2010out consent increases DTR by 38\u201383% over 11\u201313 years. These studies compared 22\u201325 opt\u2010out versus 22\u201328 opt\u2010in countries. Modeled opt\u2010out activity on the USA resulted in 4753\u201317,201 additional transplants annually.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Opt\u2010out consent increases DDR and DTR and may be useful in decreasing deaths on the waiting list in the USA and other countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Registration number<\/jats:title><jats:p>PROSPERO CRD42019098759.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05118-4","type":"journal-article","created":{"date-parts":[[2019,8,19]],"date-time":"2019-08-19T17:02:43Z","timestamp":1566234163000},"page":"3161-3171","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["A Systematic Review of Opt\u2010out Versus Opt\u2010in Consent on Deceased Organ Donation and Transplantation (2006\u20132016)"],"prefix":"10.1002","volume":"43","author":[{"given":"M. Usman","family":"Ahmad","sequence":"first","affiliation":[{"name":"Medical Edu. USF Morsani College of Medicine (MCOM) 12901 Bruce B Downs Blvd Tampa FL USA"},{"name":"Department of Surgery University of Colorado School of Medicine 80045 Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afif","family":"Hanna","sequence":"additional","affiliation":[{"name":"Medical Edu. USF Morsani College of Medicine (MCOM) 12901 Bruce B Downs Blvd Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed\u2010Zayn","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Medical Edu. USF Morsani College of Medicine (MCOM) 12901 Bruce B Downs Blvd Tampa FL USA"},{"name":"Legal Edu. Stetson University College of Law 1401 61st St S Gulfport FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Schlindwein","sequence":"additional","affiliation":[{"name":"Medical Edu. University of Cambridge School of Medicine Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Pley","sequence":"additional","affiliation":[{"name":"Medical Edu. University of Cambridge School of Medicine Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Bahner","sequence":"additional","affiliation":[{"name":"Department of Molecular Med USF MCOM 12901 Bruce B Downs Blvd MDC 7 Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Mhaskar","sequence":"additional","affiliation":[{"name":"Office of Research USF MCOM 12901 Bruce B Downs Blvd MDC 27 Tampa FL USA"},{"name":"Global Health USF College of Public Health 12901 Bruce B Downs Blvd MDC 27 Tampa FL USA"},{"name":"Department of Internal Medicine USF MCOM 12901 Bruce B Downs Blvd Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin J.","family":"Pettigrew","sequence":"additional","affiliation":[{"name":"Department of Surgery, Addenbrooke's Hospital University of Cambridge Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tambi","family":"Jarmi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine USF MCOM 12901 Bruce B Downs Blvd Tampa FL USA"},{"name":"Transplant Center Mayo Clinic Hospital San Pablo Rd S 4500 Jacksonville FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,19]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13731"},{"key":"e_1_2_17_3_1","volume-title":"2012 National Survey of Organ Donation Attitudes and Behaviors","author":"U.S. Department of Health & Human Services Health Resources and Services Administration Healthcare Systems Bureau","year":"2013"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.2194"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2009.03008.x"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2016.1222007"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265160902985019"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr619"},{"key":"e_1_2_17_9_1","unstructured":"Wales National Assembly.Health and Social Care Committee(2013) Human transplantation (Wales) act 2013. 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