Otero-Raviña F, Velasco C Rivero, Rodríguez-Martínez M, Mareque A I Díaz, Burgos R Romero, Rozados A Mariño, González-Juanatey J R, Sánchez-Guisande Jack D
Health Care Coordination Section Servicio Galego de Saúde, Santiago de Compostela, Spain.
Transplant Proc. 2005 Nov;37(9):3643-5. doi: 10.1016/j.transproceed.2005.08.051.
At present, transplantation of organs represents a therapeutic alternative, but the candidates for this treatment suffer from the scarcity of donors. We analyzed the process of the donation of organs in Galicia, an autonomous region in the northwest of Spain.
We summed all the potential donors in Galicia between January 1996 and December 2000 to analyze the reasons for nonconversion, the characteristics of the actual donors, and the use of the generated organs.
We found 779 potential donors of whom 443 (56%) became actual donors (annual rate 31.6 pmp), although an important interterritorial variability was observed. The main reason for not obtaining potential donors was family refusal (32%), with denial during life being given as the reason in 45% of these families. We observed a progressive aging of the donors (39% older than 60 years in 2000), who had a mean age of 46 +/- 18 years. There also was an increased percentage of deaths due to vascular causes (mean 53%), while traumatic deaths (mean 40%) showed an inverse tendency. Donation because of asystole represented 5%. Among all the retrievals, 90% were multiorgan, generating 1437 organs including 1227 that were transplanted, yielding 3.3 possible organs from each donor including 2.8 organs that were transplanted. Among donors younger than 45 years, the numbers increased to 3.7 and 3.4, respectively, and for donors older than 60 years, the numbers were 2.7 and 1.9, respectively.
Despite the increase in donors and organs, family refusal did not decrease, as this was the main reason for potential donor loss. Therefore it is necessary to create a regional program to promote donation.
目前，器官移植是一种治疗选择，但该治疗的候选者面临供体短缺的问题。我们分析了西班牙西北部自治区加利西亚的器官捐献过程。
我们汇总了1996年1月至2000年12月加利西亚所有潜在供体，以分析未转化为实际供体的原因、实际供体的特征以及所获取器官的使用情况。
我们发现779名潜在供体，其中443名（56%）成为实际供体（年发生率为31.6/百万人口），不过观察到存在显著的地区间差异。未获得潜在供体的主要原因是家属拒绝（32%），其中45%的家属以生前拒绝作为理由。我们观察到供体逐渐老龄化（2000年39%的供体年龄超过60岁），供体的平均年龄为46±18岁。血管性病因导致的死亡百分比也有所增加（平均53%），而创伤性死亡（平均40%）呈相反趋势。心脏停搏导致的捐献占5%。在所有获取的器官中，90%为多器官，共获取1437个器官，其中1227个器官被移植，每个供体平均可获取3.3个可能被移植的器官，其中2.8个器官被移植。在年龄小于45岁的供体中，则分别增至3.7个和3.4个，对于年龄超过60岁的供体，这两个数字分别为2.7个和1.9个。
尽管供体和器官数量有所增加，但家属拒绝并未减少，这仍是潜在供体流失的主要原因。因此，有必要制定一项区域计划以促进捐献。
