Increased Infectious Risk Donor Status and Equity-Relevant Predictors of Organ Donation Organization Approach and Caregiver Consent for Deceased Organ Donation in a Canadian Province (2015–2021)

IF 1.9 4区医学 Q2 SURGERY Clinical Transplantation Pub Date : 2024-12-21 DOI:10.1111/ctr.70058

Murdoch Leeies, Karen Doucette, Brenden Dufault, Tricia Carta, Owen Mooney, Carmen Hrymak, Nicolette Balzer, Ben Borys, Yasmine El-Salakawy, Mirna Ragheb, Davie Xie, Emily Christie, David Collister, Matthew J. Weiss, Sonny Dhanani, Julie Ho

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引用次数: 0

Abstract

Background

Current donor risk assessments to identify risk of infectious transmission through transplantation have been criticized as unnecessarily discriminatory for sexual and gender minorities. Little is known about how increased infectious risk donor (IIRD) patients transition through the deceased donation system. We sought to evaluate how IIRD status and other equity-relevant identities impacted the likelihood of a caregiver of a deceased donor being approached for organ donation and the likelihood of caregiver consent.

Methods

We conducted a retrospective, observational cohort study of potential deceased donors referred to a Canadian provincial organ donation organization (ODO) from 2015 to 2021. Our primary outcome is the difference in the likelihood of being approached by the ODO for organ donation for IIRDs compared to baseline risk donors, amongst referred potential deceased organ donors. Secondary outcomes include the difference in caregiver consent for donation for IIRDs compared to baseline risk donors, amongst approached deceased organ donors. We built multivariable logistic regression models to evaluate these outcomes.

Results

Amongst all referred potential deceased organ donors, IIRD status did not impact the likelihood of being approached by our ODO for deceased organ donation compared to baseline risk donors (OR 1.695, 95% CI 0.902–3.197). Amongst approached deceased organ donors, there was no significant difference in caregiver consent for donation between IIRD and baseline risk donors (OR 1.854, 95% CI 0.902–3.929). Approached eligible IIRDs were younger with fewer comorbidities, lower KDPI scores, were more likely to have died from anoxic brain injuries and have death determined by neurologic criteria, and more likely to have non-medical injection drug use than baseline risk donors. There were no cases of donor-derived human immunodeficiency virus (HIV), hepatitis C virus (HCV), or hepatitis B virus (HBV) reported for any donors included, regardless of IIRD status, during the study period.

Conclusions

We found no significant difference in the likelihood of ODO approach in IIRDs compared to baseline risk donors. There was no difference in caregiver consent for donation in IIRDs compared to baseline risk donors. A greater proportion of IIRDs became successful donors compared to baseline risk donors.

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.