Selck F W, Deb P, Grossman E B
New York Organ Donor Network, New York, NY, USA.
Am J Transplant. 2008 May;8(5):965-74. doi: 10.1111/j.1600-6143.2008.02205.x. Epub 2008 Mar 10.
While the function of each organ is used by each transplant team to assess suitability for transplantation, little is known about the donor characteristics and clinical interventions that contribute toward overall organ transplantation potential. We conduct a retrospective review of United Network for Organ Sharing (UNOS) deceased donor registry data from January 2005 to December 2006. This registry contains all deceased donors from whom organs were recovered during this time period (n = 15,601). Ordinary least-squares (OLS) regression models using variables in the registry are estimated to predict the number of organs transplanted. Outcome is the number of organs transplanted per donor. Organ yield is found to depend significantly on donor age, anoxia as cause of death, history of myocardial infarction (MI), hypertension and/or diabetes, body mass index (BMI), B or AB blood type, cocaine and/or cigarette use and hepatitis infection (p < 0.01). In addition, the clinical interventions of steroid administration, desmopressin (DDAVP) and diuretic usage, as well as oxygenation, are associated with organ yield. Both intrinsic donor characteristics and medical management practice are observed to be highly variable across organ procurement organizations (OPOs). These findings may provide important information to explore and assess the efficacy of clinical interventions, compare OPO performance and point to best practices.
虽然每个移植团队都会利用每个器官的功能来评估移植的适宜性,但对于有助于整体器官移植潜力的供体特征和临床干预措施却知之甚少。我们对器官共享联合网络(UNOS)2005年1月至2006年12月的已故供体登记数据进行了回顾性研究。该登记册包含了在此期间所有器官被摘取的已故供体(n = 15,601)。使用登记册中的变量估计普通最小二乘法(OLS)回归模型,以预测移植器官的数量。结果是每个供体移植器官的数量。发现器官产量显著取决于供体年龄、缺氧作为死亡原因、心肌梗死(MI)病史、高血压和/或糖尿病、体重指数(BMI)、B型或AB型血型、使用可卡因和/或香烟以及肝炎感染(p < 0.01)。此外,类固醇给药、去氨加压素(DDAVP)和利尿剂使用以及氧合等临床干预措施与器官产量有关。观察到供体的内在特征和医疗管理实践在器官获取组织(OPO)之间存在很大差异。这些发现可能为探索和评估临床干预措施的疗效、比较OPO的表现以及指出最佳实践提供重要信息。