Inaba Kenji, Branco Bernardino C, Lam Lydia, Salim Ali, Talving Peep, Plurad David, Green Donald J, Demetriades Demetrios
Division of Trauma and Surgical Critical Care, University of Southern California, 1200 North State Street, Room CL5100, Los Angeles, CA 90033-4525, USA.
J Trauma. 2010 Jun;68(6):1362-6. doi: 10.1097/TA.0b013e3181db30d3.
No consensus exists as to the maximal period of time allowable after brain death (BD) before organ procurement rates begin to deteriorate. The aim of this study was to examine organ procurement rates as a function of time after BD.
After institutional review board approval, all consented donors from 2006 through 2008 were identified from the regional Organ Procurement Organization. Demographics, organ procurement data, and the time from BD to procurement were abstracted. The organ's procured to consented ratio was analyzed from the time of BD to organ recovery in 6-hour intervals.
Of 1,554 consented organ donors, 678 (46.3%) were trauma patients. Mean age was 37.1 years +/- 17.6 years; 62.6% were male. The mean time from BD to procurement was 34.5 hours +/- 19.8 hours. A total of 3,340 (44.8%) organs (kidneys 95.4%, livers 80.5%, hearts 36.0%, pancreas 24.9%, lungs 13.0%, and intestines 2.9%) were procured out of the 7,451 that were consented for. Poor organ function was the primary reason for nonprocurement. For each organ analyzed individually and all organs combined, there was no decrease in the procurement to consented ratio with increasing time after BD. There was also no increase in the number of organs nonprocured because of poor organ function.
Increasing time interval between BD and organ procurement was not associated with decreased organ procurement rates or an increased number of nonsalvageable organs because of poor organ function. Further investigation of the impact of this delay on long-term organ function is warranted.
关于脑死亡(BD)后在器官获取率开始下降之前允许的最长时间,目前尚无共识。本研究的目的是检查器官获取率作为脑死亡后时间的函数。
经机构审查委员会批准后,从区域器官获取组织中识别出2006年至2008年所有同意捐赠的供体。提取人口统计学数据、器官获取数据以及从脑死亡到获取的时间。从脑死亡到器官恢复的时间以6小时间隔分析获取器官与同意捐赠器官的比例。
在1554名同意捐赠器官的供体中,678名(46.3%)为创伤患者。平均年龄为37.1岁±17.6岁;62.6%为男性。从脑死亡到获取的平均时间为34.5小时±19.8小时。在7451个同意捐赠的器官中,共获取了3340个(44.8%)器官(肾脏95.4%,肝脏80.5%,心脏36.0%,胰腺24.9%,肺13.0%,肠道2.9%)。器官功能不佳是未获取器官的主要原因。对于单独分析的每个器官以及所有器官综合起来,随着脑死亡后时间的增加,获取与同意捐赠的比例没有下降。因器官功能不佳而未获取的器官数量也没有增加。
脑死亡与器官获取之间的时间间隔增加与器官获取率降低或因器官功能不佳导致的不可挽救器官数量增加无关。有必要进一步研究这种延迟对长期器官功能的影响。