Jendrisak Martin D, Hruska Keith, Wagner Jessica, Chandler Diane, Kappel Dean
Department of Surgery, Transplantation Section, Washington University School of Medicine, St. Louis, MO 63110, USA.
Transplantation. 2002 Oct 15;74(7):978-82. doi: 10.1097/00007890-200210150-00014.
Of the many logistic issues addressed throughout the cadaveric organ donation process, timely access to the operating theater for surgical recovery of organs and tissues can be one of the most problematic. Delay in recovery adds to cost, risks organ viability, and compounds donor family anguish with compromise to donation consent.
From March 1 to November 30, 2001, 25 cadaveric donors were selected and successfully transferred from local donor critical care units to an off-site facility, which was constructed, equipped, and staffed to allow surgical recovery of organs and tissues. Assessment of the recovery process and outcome results was compared to 42 consecutive, hospital-based, organ recoveries within the Mid-American Transplant Services (MTS) organ procurement organization region.
Twenty-five MTS-facility and 42 hospital organ recoveries were successfully conducted with no technical losses and satisfactory function in all 206 transplanted organs. From the MTS donor group, 7 hearts, 4 lungs, 21 livers, 28 kidneys, and 5 pancreases were successfully transplanted. Statistically significant in the MTS group was higher donor age (44.1 vs. 30.2 years), shorter total donor management time (539 vs. 718 min), reduced delay in start of surgery (25 vs. 77 min), shorter cold ischemia time for recovered pancreases (355 vs. 630 min), and reduced mean cost per donor ($10,636 vs. $12,918). There was no significant difference in race, gender, cause of death, vasopressor requirements, organs per donor recovered (3.12 vs. 3.62) or transplanted (2.60 vs. 3.36), rate of tissue recoveries (68% vs. 67%), total operating room time (207 vs. 200 min.), or cold ischemia time (excluding pancreas).
Cadaveric-donor multiorgan and tissue recovery at this hospital-independent facility was successfully accomplished in a manner indistinguishable from conventional hospital organ and tissue recovery. The intended objectives of improved access to the operating theater were realized along with the added benefit of significant cost savings and convenience to hospital personnel and surgical recovery teams.
在尸体器官捐献过程中涉及的众多后勤问题中，及时进入手术室进行器官和组织的手术获取可能是最具问题的环节之一。获取延迟会增加成本、危及器官的存活能力，并因捐赠同意受到影响而加重捐赠者家属的痛苦。
2001年3月1日至11月30日，选择了25名尸体捐赠者，并成功将他们从当地的捐赠者重症监护病房转移到一个异地设施，该设施已建成、配备齐全并配备了工作人员，以进行器官和组织的手术获取。将获取过程和结果的评估与中美移植服务（MTS）器官采购组织区域内连续42例基于医院的器官获取进行了比较。
成功进行了25例MTS设施的器官获取和42例医院的器官获取，所有206个移植器官均无技术损失且功能良好。在MTS捐赠者组中，成功移植了7颗心脏、4个肺、21个肝脏、28个肾脏和5个胰腺。MTS组在统计学上有显著差异的是捐赠者年龄较大（44.1岁对30.2岁）、捐赠者总管理时间较短（539分钟对718分钟）、手术开始延迟减少（25分钟对77分钟）、获取的胰腺冷缺血时间较短（355分钟对630分钟）以及每位捐赠者的平均成本降低（10,636美元对12,918美元）。在种族、性别、死因、血管升压药需求、每位捐赠者获取（3.12对3.62）或移植（2.60对3.36）的器官数量、组织获取率（68%对67%）、总手术室时间（207分钟对200分钟）或冷缺血时间（不包括胰腺）方面没有显著差异。
在这个独立于医院的设施中成功完成了尸体捐赠者的多器官和组织获取，其方式与传统医院的器官和组织获取没有区别。实现了改善进入手术室机会的预期目标，同时还带来了显著节省成本以及方便医院工作人员和手术获取团队的额外好处。
