Badovinac Kim, Greig Paul D, Ross Heather, Doig Christopher J, Shemie Sam D
Canadian Institute for Health Information, Toronto General Hospital-University Health Network, Ontario, Canada.
Can J Anaesth. 2006 Aug;53(8):838-44. doi: 10.1007/BF03022802.
Optimizing organ utilization from consented donors is a critical need, given a static organ donation rate. We report changes in the characteristics of donors and organ utilization patterns in Canada over a ten-year period.
For the decade spanning the years 1993-2002, data were extracted from the Canadian Organ Replacement Register (CORR), the national transplant registry. A donor was defined as a deceased person from whom at least one vital organ was retrieved and transplanted.
The donor pool is aging (median age of donors increased eight years over the decade), with proportionately fewer donors dying from head trauma (motor vehicle collisions) and proportionately more from cerebrovascular accidents. At least four organs were utilized from approximately half the donors. These donors were significantly younger every year over the sampling period when compared with donors where < or = three organs were utilized. In 2002, utilization rates were: 87.0% (kidneys), 85.0% (livers), 42.2% (hearts), 30.6% (pancreata), 28.3% (lungs), and < or = 1% (intestines). There was increased utilization of donor pancreata, lungs and liver over the decade, but a flat utilization pattern for hearts, and a small decline in kidney utilization. Utilization rates vary from province to province.
Trends in the Canadian organ donor pool are characterized by an increasing age and a shift towards cerebrovascular diseases as primary causes of death. In order to improve organ utilization and understand regional variability, the scope of data provided to the national registry requires enhanced detail to address the factors that lead to non-utilization. Addressing the low utilization rates for hearts and lungs is especially critical, given the need for thoracic transplantation in Canada.
鉴于器官捐献率停滞不前，优化来自已同意捐献者的器官利用是一项迫切需求。我们报告了加拿大十年间捐献者特征及器官利用模式的变化。
在1993年至2002年这十年间，数据取自加拿大器官替代登记处（CORR），即国家移植登记处。捐献者定义为至少有一个重要器官被摘取并移植的已故人员。
捐献者群体老龄化（十年间捐献者的中位年龄增加了8岁），因头部创伤（机动车碰撞）死亡的捐献者比例相应减少，因脑血管意外死亡的捐献者比例相应增加。约一半的捐献者至少有四个器官被利用。与利用器官数≤3个的捐献者相比，在抽样期间，每年这些捐献者都明显更年轻。2002年的利用率分别为：肾脏87.0%、肝脏85.0%、心脏42.2%、胰腺30.6%、肺28.3%、肠道≤1%。十年间，胰腺、肺和肝脏的捐献者器官利用率有所提高，但心脏的利用率保持平稳，肾脏利用率略有下降。各省的利用率各不相同。
加拿大器官捐献者群体的趋势特点是年龄增长以及作为主要死亡原因的疾病向脑血管疾病转变。为了提高器官利用率并了解区域差异，提供给国家登记处的数据范围需要更详细，以解决导致器官未被利用的因素。鉴于加拿大对胸科移植的需求，解决心脏和肺的低利用率尤其关键。
