Englesbe M J, Merion R M
Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Am J Transplant. 2009 Oct;9(10):2406-15. doi: 10.1111/j.1600-6143.2009.02774.x. Epub 2009 Aug 6.
Transplant surgeons are exposed to workplace risk due to the urgent nature of travel related to organ procurement. A retrospective cohort study was completed using data from the Scientific Registry of Transplant Recipients and the National Transportation Safety Board. A web-based survey was administered to members of the American Society of Transplant Surgeons. The survey response rate was 38% (281/747). Involvement in > or =1 procurement-related travel accident was reported by 15% of respondents; surgeons reported 61 accidents and 11 fatalities. Air travel was used in 26% of procurements and was involved in 56% of accidents. The risk of fatality while traveling on an organ procurement flight was estimated to be 1000 times higher than scheduled commercial flight. Involvement in a 'near miss accident' was reported by 80.8%. Only 16% of respondents reported feeling 'very safe' while traveling. Procurement of organs by the geographically closest transplant center would have reduced the need for air travel (>100 nautical miles) for lung, heart, liver and pancreas procurement by 35%, 43%, 31% and 49%, respectively (p < 0.0001). These reductions were observed in each Organ Procurement and Transplantation Network region. Though these data have important limitations, they suggest that organ procurement travel is associated with significant risk. Improvements in organ procurement travel are needed.
由于器官获取相关行程的紧迫性，移植外科医生面临工作场所风险。利用移植受者科学登记处和国家运输安全委员会的数据完成了一项回顾性队列研究。对美国移植外科医生协会的成员进行了一项基于网络的调查。调查回复率为38%（281/747）。15%的受访者报告曾参与≥1次与获取相关的旅行事故；外科医生报告了61起事故和11起死亡事件。26%的器官获取行程使用了航空旅行，且航空旅行涉及56%的事故。据估计，乘坐器官获取航班旅行时的死亡风险比定期商业航班高1000倍。80.8%的受访者报告曾遭遇“险些发生的事故”。只有16%的受访者表示旅行时感觉“非常安全”。由地理位置最接近的移植中心进行器官获取，将分别使肺、心脏、肝脏和胰腺获取时航空旅行（>100海里）的需求减少35%、43%、31%和49%（p<0.0001）。在每个器官获取和移植网络区域均观察到了这些减少情况。尽管这些数据有重要局限性，但它们表明器官获取旅行存在重大风险。需要改进器官获取旅行。
