Infant Organ Donation After Death by Circulatory Criteria: A Literature Scoping Review
Bibliographic record
Abstract
OBJECTIVES: Infant organ donation is rare but when it does occur, infants are more commonly eligible for donation after circulatory death (DCD) than donation after neurological death. The aims of this scoping review were to identify: 1) existing research, ethical, and policy information about infant organ DCD and 2) knowledge gaps to guide future research. DATA SOURCES: A literature search of MEDLINE, Embase, CINAHL, Scopus, and the Web of Science up to 2024. No other date or search limits were applied. A gray literature search for policy and clinical guideline documents was also conducted. STUDY SELECTION: Two reviewers independently screened titles and abstracts, then article full texts. The search yielded 8176 unique publications of which 33 were included in this review. The gray literature search yielded six relevant documents. DATA EXTRACTION: Data were extracted by one reviewer according to the type of article (e.g., donor audit; time to death studies; transplant outcome studies; ethical commentary; position; or policy statements). DATA SYNTHESIS: The article narratives fell into six topics, including: 1) donor audits and criteria; 2) donor care and referral practices; 3) predictors of time to death; 4) transplant outcomes; 5) ethical issues; and 6) strategies to increase infant organ donation. Donor audits suggest that infant donors are under-recognized, despite good transplantation outcomes in transplant reports. While some predictors of time to death were identified, further research is needed. Several ethical issues were highlighted including debate about permanence vs. irreversibility of death as a requirement for DCD. Families of all potentially eligible infants should be offered the option for donation as part of routine care, with high-quality end-of-life care provided regardless of whether donation occurs. CONCLUSIONS: Infant DCD remains an uncommon practice worldwide. Ongoing research is crucial to furthering the field of infant DCD and increasing the number of available organs.
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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 | 0.018 | 0.085 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.027 | 0.023 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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".