Madsen M, Bøgh L
Department of Renal Medicine, Aarhus University Hospital, Skejby Sygehus, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
Transplant Proc. 2005 Oct;37(8):3258-9. doi: 10.1016/j.transproceed.2005.09.012.
To estimate the organ donor potential in Denmark we conducted a prospective registration of deaths in all intensive care units (ICUs), counting 15 ICUs and two neurosurgical ICUs in the four northern Danish counties, which cover a population of 1.64 million inhabitants or 30% of the Danish population. From September 1, 2000 till August 31, 2002, all deaths in the ICUs in 15 hospitals were recorded. Each case was evaluated locally postmortem with respect to medical suitability to organ donation. A total of 1655 deaths were recorded, corresponding to 504 deaths per million population per year (PMP). Median age was 70 years (0 to 99 years), 52% were more than 70 years, and 22% more than 80 years of age. The cause of death was cerebral lesion in 18% of the cases (neurosurgical ICUs: n = 182; ICUs: n = 110). By thorough medical record examination, the number of potential donors was estimated to be 169, corresponding to 51 PMP. The cause of death was cerebral lesion in 96% of the potential donors. Organ donation was performed in 43 cases (32 from neurosurgical ICUs and 11 from ICUs) or 13.1 PMP. Thus, 25% of the potential became organ donors. The major reason for nondonation was refusal from the relatives. Out of 127 questioned, the relatives refused in 62 cases (49%). By comparison, 74% of the general Danish population are willing to donate organs after death. The rate of nondetection of potential donors by the hospital staff could be estimated to 22%. In conclusion, the organ donor potential may allow for improvement in donation rates. An increased effort for donor hospitals is warranted. The motives for refusal by the relatives need elucidation.
为评估丹麦的器官捐献者潜力，我们对所有重症监护病房（ICU）的死亡情况进行了前瞻性登记，涵盖丹麦北部四个郡的15个ICU和两个神经外科ICU，这些地区人口为164万，占丹麦总人口的30%。从2000年9月1日至2002年8月31日，记录了15家医院ICU的所有死亡情况。每例死亡病例在当地进行尸检，评估其器官捐献的医学适宜性。共记录了1655例死亡，相当于每年每百万人口中有504例死亡（PMP）。中位年龄为70岁（0至99岁），52%的患者年龄超过70岁，22%的患者年龄超过80岁。18%的病例死亡原因是脑部病变（神经外科ICU：n = 182；ICU：n = 110）。通过详细检查病历，估计潜在捐献者数量为169例，相当于51 PMP。96%的潜在捐献者死亡原因是脑部病变。43例进行了器官捐献（32例来自神经外科ICU，11例来自ICU），即13.1 PMP。因此，25%的潜在捐献者成为了器官捐献者。未进行捐献的主要原因是亲属拒绝。在127名接受询问的亲属中，62例（49%）拒绝了。相比之下，74%的丹麦普通民众愿意在死后捐献器官。医院工作人员未发现潜在捐献者的比例估计为22%。总之，器官捐献者潜力可能有助于提高捐献率。有必要加大对捐献医院的工作力度。亲属拒绝的动机需要阐明。
