227.2: Organ donation recovery during the first two years of the covid-19 pandemic: a comparison of Canada with Australia, Spain, the United Kingdom, and the United States
Bibliographic record
Abstract
Introduction: The COVID-19 pandemic challenged organ donation programs around the world, as many health systems shifted resources towards the surge of critically ill COVID-19 patients and limited donation and transplant activity. With signs of health system recovery becoming evident, the aim of this study is to compare organ donation rates between Canada, Australia, Spain, the United Kingdom (UK), and the United States (US) across three periods: pre-pandemic (2019), the first pandemic year (2020), and the second pandemic year (2021). Methods: Patients registered in the Canadian Organ Replacement Register who donated an organ that was utilized for transplantation in Canada between 2019 and 2021 were identified. For the same time period, aggregated donation data from Australia, Spain, UK and US were obtained from the Global Observatory on Donation and Transplantation. Values for deceased donors (DD) (including neurological determination of death (NDD) donors vs. donors after circulatory determination of death (DCD)) and living donors were compared between countries and across years to determine the impact of COVID-19 on organ donation activity. Results: Only the US did not experience a decrease in DD following the onset of COVID-19, instead increasing by 12% between 2019 and 2021. Australia, Canada, Spain, and the UK all experienced decreases in DD in the first year of the pandemic (-14%, -11%, -20%, -23%, respectively), and despite some improvements in Spain and the UK in 2021 (+7% for both compared to 2020), none of these four countries have recovered to pre-pandemic levels (Table 1). Canada and Spain experienced a greater decrease in NDD donors than DCD donors from 2019 to 2021 (Canada: -14% vs. -5%; Spain: -19% vs. -6%, respectively), while the opposite was true for Australia (decrease of -29% in DCD and -18% in NDD). The UK saw a similar level of decrease in both NDD and DCD levels (-18% and -16%, respectively). The only country to experience an increase was the US, with a +4% improvement in NDD donors and +39% improvement in DCD donors from 2019 to 2021 (Table 1).While total living donations in Australia, Canada, Spain, the UK, and the US were all lower in 2021 compared to 2019 (-15%, -3%, -9%, -28%, -11%, respectively) (Table 2), all five countries did experience an increase in living kidney donors in 2021 (+12%, +27%, +25%, +31%, +14%). Further, Canada increased the number of living liver donations in both the first (+14%) and second (+2%) year of the pandemic, while the US had more living liver donations in 2021 compared to 2019 (+10%) (Table 2).Conclusions: The COVID-19 pandemic impacted organ donation on a global scale. While signs of improvement are already apparent, donation recovery has been unique to each country. More detailed data such as number of eligible donors or rate of consent for donation during the pandemic will be required to understand the causes of these differences.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".