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)
Bibliographic record
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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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".