Lewis Jonathan, Peltier James, Nelson Helen, Snyder William, Schneider Kristi, Steinberger Dina, Anderson Michael, Krichevsky Alexander, Anderson James, Ellefson Jill, D'Alessandro Anthony
University of Wisconsin Hospital and Clinics Organ Procurement Organization, Madisin, Wis, USA.
Prog Transplant. 2003 Dec;13(4):265-73. doi: 10.1177/152692480301300405.
Donation after cardiac death is a method by which severely neurologically injured patients not fulfilling brain-death criteria can donate organs.
To develop an evaluation tool that can be used to predict if a patient is a suitable candidate for donation after cardiac death.
The University of Wisconsin Donation After Cardiac Death Evaluation Tool assigns numeric values to observable clinical parameters to yield an overall predictive score of suitability for donation after cardiac death. This evaluation tool is typically utilized in a critical care unit to evaluate patients with a severe neurological injury, who do not meet brain-death criteria, and for whom the physician and family have chosen to terminally withdraw life support. Each patient is disconnected from a ventilator and observed for up to 10 minutes. Observations are then scored to yield a prediction of suitability for donation after cardiac death.
Using the University of Wisconsin Donation After Cardiac Death Evaluation Tool, we were able to predict suitability for donation after cardiac death 83.7% of the time, within a 60-minute period and 74.4% of the time within a 120-minute period. The actual results using the tool were higher when clinical observations were included in the donation after cardiac death evaluation--an overall accuracy of 88.4%.
心脏死亡后器官捐献是一种让不符合脑死亡标准但神经严重受损的患者能够捐献器官的方法。
开发一种评估工具，用于预测患者是否是心脏死亡后器官捐献的合适候选人。
威斯康星大学心脏死亡后器官捐献评估工具为可观察的临床参数赋予数值，以得出心脏死亡后器官捐献适宜性的总体预测分数。该评估工具通常在重症监护病房用于评估不符合脑死亡标准、医生和家属已选择终止维持生命治疗的严重神经损伤患者。让每位患者脱离呼吸机并观察长达10分钟。然后对观察结果进行评分，以预测心脏死亡后器官捐献的适宜性。
使用威斯康星大学心脏死亡后器官捐献评估工具，我们能够在60分钟内83.7%的时间预测心脏死亡后器官捐献的适宜性，在120分钟内74.4%的时间做出预测。当在心脏死亡后器官捐献评估中纳入临床观察时，使用该工具的实际结果更高——总体准确率为88.4%。
