Ploeg Rutger J, Niesing Jan, Sieber-Rasch Monique H, Willems Linda, Kranenburg Koos, Geertsma Albert
Department of Surgery, University Hospital Groningen, The Netherlands.
Transplantation. 2003 Sep 27;76(6):948-55. doi: 10.1097/01.TP.0000079317.75840.0F.
A major problem in the field of transplantation is the persistent shortage of donor organs and tissues for transplantation. This study was initiated to (1) chart the donor potential for organs and tissue in The Netherlands and (2) to identify factors influencing whether donation is discussed with next of kin.
A registration form was constructed to obtain information at time of death of patients about the demographic characteristics, diagnosis, and medical suitability for donation. A prospective study was conducted among 11 hospitals in The Netherlands that gathered 4,877 filled-in forms equaling 8% to 10% of the people dying in a hospital in The Netherlands per year.
In the year of the study, organs were retrieved from 22 donors and tissues from 264 donors in the 11 hospitals. The organ potential is estimated at a maximum of 38.7 per million population per year. A mere 5% of the physicians got a 100% score on criteria and contraindications for donation. Factors of influence on receiving consent for donation were the will of the donor, using a protocol, giving verbal information to the relatives, and presence of the partner of the deceased patient. For 26% of the potential tissue donors and 69% of the potential organ donors, donation was discussed with the relatives. Consent for tissue donation was obtained in 27%, and consent for organ donation was obtained in 60%.
In The Netherlands, when taking into account current refusal percentages, 320 to 360 organ donations and 5,800 tissue donations could be effectuated if organ donation is posed to all possible donors. For this, knowledge of medical criteria and contraindications for donation by the physicians and their willingness to discuss donation with next of kin must be improved.
移植领域的一个主要问题是用于移植的供体器官和组织持续短缺。开展本研究旨在：（1）描绘荷兰器官和组织的供体潜力；（2）确定影响是否与近亲讨论捐赠事宜的因素。
设计了一份登记表，以便在患者死亡时获取有关人口统计学特征、诊断及捐赠医学适宜性的信息。在荷兰的11家医院进行了一项前瞻性研究，收集了4877份填写完整的表格，相当于荷兰每年在医院死亡人数的8%至10%。
在研究当年，11家医院从22名供体获取了器官，从264名供体获取了组织。器官潜力估计最高为每年每百万人口38.7个。只有5%的医生在捐赠标准和禁忌方面得满分。影响获得捐赠同意的因素包括供体意愿、使用方案、向亲属提供口头信息以及已故患者伴侣的在场情况。对于26%的潜在组织供体和69%的潜在器官供体，与亲属讨论了捐赠事宜。获得组织捐赠同意的比例为27%，获得器官捐赠同意的比例为60%。
在荷兰，如果向所有可能的供体提出器官捐赠，考虑到目前的拒绝率，每年可实现320至360例器官捐赠和5800例组织捐赠。为此，必须提高医生对捐赠医学标准和禁忌的了解以及他们与近亲讨论捐赠的意愿。
