215.9: Prospect of an organ donation after uncontrolled death by circulatory criteria program in Canada: Perspectives of leaders and key stakeholders.
Bibliographic record
Abstract
Background: Although organ donation rates in Canada have improved over recent years, particularly through donation after death determined by circulatory criteria (DCC), the demand for organs continues to significantly outpace supply. This persistent shortfall highlights the urgent need to explore innovative strategies to expand donation opportunities and practices. An approach that is used internationally, donation after uncontrolled death by circulatory criteria (UDCC), involves organ recovery following unexpected cardiac arrest. While UDCC programs have been successfully implemented in several countries, they remain largely unexamined in the Canadian healthcare landscape. This study aims to explore the perspectives of key leaders and stakeholders in the Canadian organ donation and transplantation system to better understand the factors that may influence the development and implementation of UDCC programs nationally. Methods: This qualitative descriptive study is currently underway and involves conducting semi-structured virtual interviews with key leaders and stakeholders in organ donation and transplantation organizations across Canada. The goal is to gather insights into the potential implementation of uncontrolled DCC programs. Interviews are being recorded, transcribed verbatim, and analyzed using an inductive approach to identify and organize recurring codes and themes that reflect participants’ perspectives. Preliminary Results: To date, we have conducted interviews with 19 key leaders and stakeholders across both national and provincial donation and transplantation programs, with representation from British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and Nova Scotia. Preliminary analysis reveals a range of complex and inter-related challenges that could affect the feasibility of implementing UDCC programs in Canada. These include logistical barriers, ethical considerations, geographic disparities, economic constraints, and limitations in available resources and current healthcare capacity. There was a strong consensus among participants on the need for evidence-based data to assess the potential impact of such programs on donation rates. The importance of maintaining public trust and ensuring that any new initiatives align with the overarching goal of saving lives was also voiced. Some leaders identified opportunities to explore alternative pathways, such as extracorporeal membrane oxygenation (ECMO) donation and expanded tissue donation initiatives. Conclusion: Final results from this ongoing project will be presented at the 2025 International Society for Organ Donation Professionals Congress. Insights gained from this research have the potential to inform national conversations on pathways for supporting and advancing donation practices in Canada in unexpected circumstances.
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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 | 0.004 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.030 | 0.006 |
| Scholarly communication | 0.006 | 0.001 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.004 |
| 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".