Department of Health Services Research and Policy, Policy Innovation and Evaluation Research Unit, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Clinical Research and Development, Royal Marsden NHS Foundation Trust, London, United Kingdom.
PLoS One. 2024 Jul 31;19(7):e0306541. doi: 10.1371/journal.pone.0306541. eCollection 2024.
In May 2020, England implemented soft 'opt-out' or 'deemed consent' for deceased donation with the intention of raising consent rates. However, this coincided with the COVID-19 pandemic, making it difficult to assess the early impact of the law change. Wales and Scotland changed their organ donation legislation to implement soft opt-out systems in 2015 and 2021 respectively. This study provides a descriptive analysis of changes in consent and transplant rates for deceased organ donation in England, Scotland and Wales.
Logistic regression and descriptive trend analysis were employed to assess the probability of a patient who died in critical care becoming a donor, and to report consent rates using data, respectively, from the Intensive Care National Audit and Research Centre (ICNARC) in England from 1 April 2014 to 30 September 2021, and from the Potential Donor Audit for England, Scotland and Wales from April 2010 to June 2023.
The number of eligible donors in April-June 2020 were 56.5%, 59.3% and 57.6% lower in England, Scotland and Wales relative to April-June 2019 (pre-pandemic). By April-June 2023, the number of eligible donors had recovered to 87.4%, 64.2% and 110.3%, respectively, of their levels in 2019. The consent rate in England, Scotland and Wales reduced from 68.3%, 63.0% and 63.6% in April-June 2019 to 63.2%, 60.5% and 56.3% in April-June 2023.
While the UK organ donation system shows signs of recovery from the COVID-19 pandemic, the number of eligible potential donors and consent rates remain below their pre-pandemic levels.
2020 年 5 月，英国对已故者捐赠实行软性“选择退出”或“视为同意”，旨在提高同意率。然而，这恰逢 COVID-19 大流行，使得评估法律变更的早期影响变得困难。威尔士和苏格兰分别于 2015 年和 2021 年修改了其器官捐赠立法，以实行软性选择退出制度。本研究对英格兰、苏格兰和威尔士已故器官捐赠中同意率和移植率的变化进行了描述性分析。
采用逻辑回归和描述性趋势分析，评估了在重症监护中死亡的患者成为捐赠者的可能性，并分别使用英格兰重症监护国家审计和研究中心（ICNARC）的数据报告 2014 年 4 月 1 日至 2021 年 9 月 30 日和英格兰、苏格兰和威尔士潜在供体审计的数据报告同意率。
与 2019 年（大流行前）同期相比，2020 年 4 月至 6 月期间，英格兰、苏格兰和威尔士符合条件的捐赠者人数分别减少了 56.5%、59.3%和 57.6%。到 2023 年 4 月至 6 月，符合条件的捐赠者人数分别恢复到 2019 年的 87.4%、64.2%和 110.3%。英格兰、苏格兰和威尔士的同意率从 2019 年 4 月至 6 月的 68.3%、63.0%和 63.6%降至 2023 年 4 月至 6 月的 63.2%、60.5%和 56.3%。
尽管英国器官捐赠系统显示出从 COVID-19 大流行中复苏的迹象，但符合条件的潜在捐赠者人数和同意率仍低于大流行前水平。
