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Hike in organ donations up after bike rallies, say experts

Major US motorcycle rallies were linked to increased organ donation and transplants, a retrospective cross-sectional study showed, with medical experts recommending that more safety precautions are implemented, and that high risk sports like skydiving and cycling should encourage participants to donate organs in the event of fatalities.

Compared with the four weeks before and after rallies, there was an estimated 21% more organ donors daily during the rallies (incidence rate ratio [IRR] 1.21, 95% CI 1.09-1.35, P=0.001), and 26% more transplant recipients per day (IRR 1.26, 95% CI 1.12-1.42, P<0.001), reported Dr Anupam Jena of Harvard Medical School in Boston, and colleagues.

“This amounts to one additional donor or six additional transplant recipients in these regions for every two major motorcycle rallies,” they wrote in JAMA Internal Medicine.

“Because the timing of these rallies is plausibly unrelated to demand for organs and because we found no such effect for non-motor vehicle-related donor deaths, our findings are probably due to an increase in motorcycle use in areas where large rallies are held,” the team said.

Over nine days – the mean duration of a motorcycle rally – the net effect of motorcycle rallies resulted in 14% more organ donors and 19% more transplant recipients per day during rally dates versus non-rally dates (IRR 1.14, 95% CI 1.01-1.30, P=0.04).

“During motorcycle rally weeks in distant regions not containing motorcycle rallies, there was no increase in the number of organ donations or transplants, suggesting our observed main effect was associated with the rallies rather than other temporal factors such as vacation travel,” they wrote.

In an accompanying editorial, Dr Grace Yuan Zhang of the University of California San Francisco, and Dr Mitchell Katz of NYC Health + Hospitals in New York City noted that “these findings are not surprising, given the high mortality associated with motorcycle accidents”.

“Professional and social organisations associated with high-risk sports (not just motorcycle riding but others such as base-jumping, outdoor climbing, or skydiving, for example) should encourage participants to specify that they wish to donate their organs when they die in the future,” they added. “The findings of (this study) provide a reminder to practise safety while practising high-risk activities and to consider opting-in to become an organ donor to help save lives.”

For this study, Jena and colleagues used data from the Scientific Registry of Transplant Recipients on 10 798 organ donors ages 16 and up who died after being involved in a motor vehicle crash and 35 329 organ recipients from these donors from March 2005 to September 2021.

They looked at seven rallies, and during the rally dates, there were 406 organ donors and 1 400 transplant recipients compared with 2 332 organ donors and 7 714 transplant recipients during the four weeks before and after the rallies.

Of the donors, 70.9% were men, and mean age was 32.5, while 64% of organ recipients were men, and mean age was 49.3. Kidney, liver, heart, and lung transplants were most common.

Similar baseline and clinical characteristics of donors and recipients, including recipient waiting time and disease severity, were observed during the rally and non-rally dates. However, more donors during rallies were from racial minority groups compared with donors during non-rally dates (19% vs 14%, P=0.01).

Jena and team noted that the observational design of the study, as well as possible residual confounding, were study limitations. The study also did not assess whether the increase in organ transplants during the rallies improved transplant outcomes.

Study details

Organ Donation and Transplants During Major US Motorcycle Rallies

David Cron,  Christopher Worsham,  Joel Adler et al.

Published in JAMA on 28 November 2022

Key Points
Question Is the incidence of organ donation and transplants higher during major US motorcycle rallies?
Findings In this cross-sectional study of 10 798 organ donors and 35 329 recipients of these organs from a national transplant registry from 2005 to 2021, there were 21% more organ donors and 26% more transplant recipients per day during motorcycle rallies in regions near those rallies compared with the 4 weeks before and after the rallies.
Meaning While safety measures to minimise morbidity and mortality during motorcycle rallies should be prioritised, this study showed the downstream association of these events with organ donation and transplants.

Abstract

Importance
Large-scale motorcycle rallies attract thousands of attendees and are associated with increased trauma-related morbidity and mortality.

Objective
To examine the association of major US motorcycle rallies with the incidence of organ donation and transplants.

Design, Setting, and Participants
This population-based, retrospective cross-sectional study used data from the Scientific Registry of Transplant Recipients for deceased organ donors aged 16 years or older involved in a motor vehicle crash and recipients of organs from these donors from March 2005 to September 2021.

Main Outcomes and Measures
The main outcomes were incidence of motor vehicle crash–related organ donation and number of patients receiving a solid organ transplant from these donors. An event study design was used to estimate adjusted rates of organ donation during the dates of seven major US motorcycle rallies compared with the 4 weeks before and after the rallies in rally-affected and rally-unaffected (control) regions. Donor and recipient characteristics and metrics of organ quality were compared between rally and non-rally dates.

Results
The study included 10 798 organ donors (70.9% male; mean [SD] age, 32.5 [13.7] years) and 35 329 recipients of these organs (64.0% male; 49.3 [15.5] years). During the rally dates, there were 406 organ donors and 1 400 transplant recipients. During the four weeks before and after the rallies, there were 2 332 organ donors and 7 714 transplant recipients. Donors and recipients during rally and non-rally dates were similar in demographic and clinical characteristics, measures of organ quality, measures of recipient disease severity, and recipient waiting time. During rallies, there were 21% more organ donors per day (incidence rate ratio [IRR], 1.21; 95% CI, 1.09-1.35; P = .001) and 26% more transplant recipients per day (IRR, 1.26; 95% CI, 1.12-1.42; P < .001) compared with the four weeks before and after the rallies in the regions where they were held.

Conclusions and Relevance
In this cross-sectional study, major motorcycle rallies in the US were associated with increased incidence of organ donation and transplants. While safety measures to minimize morbidity and mortality during motorcycle rallies should be prioritised, this study showed the downstream association of these events with organ donation and transplants.

 

JAMA Internal Medicine article – Organ Donation and Transplants During Major US Motorcycle Rallies (Open access)

 

JAMA accompanying editorial: Saving Lives Out of Motorcycle Tragedies

 

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Why I gave my kidney to a stranger — and why you should, too

 

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