Background: The COVID-19 pandemic has disrupted all aspects of the international organ donation and transplantation (ODT) system. Multiple organizations have developed guidance, but to date, no comparative summary has emerged to understand differences in existing recommendations. Methods: We developed and applied a comparative methodology to a convenience sample of recommendations available on The Transplantation Society website. Document types were classified according to characteristics such as type of organization (e.g. governing body or professional society) and geographic region. Recommendations were grouped according to content and summaries were posted on a public website. This process is ongoing and will be updated as new recommendations become available. Results: 18 documents were extracted in the initial review. All documents were based on expert opinion, and none described a formal literature review or adherence with clinical guideline development processes. Recommendation categories included screening of potential donors, risk assessment of potential recipients, post-transplant risk, living/paired donation, protection of ODT professionals, and ethics/logistics. While many documents included similar recommendations, such as the need to screen and test patients who are potential donors, there was variation on some topics. Type of recommended laboratory testing varied with 64% recommending nasopharyngeal swabs, 43% oropharyngeal, and 24% bronchial aspirates. Updated results are available at https://cdtrp.ca/en/covid-19-international-recommendations-for-odt/ Conclusion: The current state of COVID-19 ODT recommendations are limited to expert opinion. Substantial variation exists regarding recommendations, which are based on emerging, but currently low-quality evidence. This summary of existing recommendations will serve to inform priorities for evidence-based recommendations. Funding: This work was supported by financial and in-kind contributions from Canadian Blood Services and the Canadian Donation and Transplant Research Program. Disclosure: The authors declare no conflicts of interest. No author has a conflicting interest with a for-profit entity. All authors are either employees or consultants for not-for profit, governmental organ donation organizations or research organizations as listed in the affiliations. Authorship: All authors have reviewed and approve of the final manuscript, which represents original work. All authors participated in the design of the review. MJW, JL, LH, and AH participated in the performance of the research and analysis of the results. MJW and JL prepared the original draft. Corresponding Author: Matthew Weiss, M.D., FRCPC Pediatric Intensivist at the Centre Mère-Enfant Soleil du CHU de Québec Medical Director of Organ Donation at Transplant Québec 3-880 Calixa-Lavallée Québec, Québec, G1S 3G9 Canada Cell: 418-717-6418 Email: matthew-john.weiss@chudequebec.ca Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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