Division of Newborn Medicine, Children's Hospital Boston, Boston, MA, USA.
J Pediatr. 2011 Jan;158(1):31-6. doi: 10.1016/j.jpeds.2010.06.055. Epub 2010 Aug 21.
To determine the percentage of deaths in level III neonatal intensive care unit (NICU) settings that theoretically would have been eligible for donation after cardiac death (DCD), as well as the percentage of these who would have been potential DCD candidates based on warm ischemic time.
We conducted a retrospective study of all deaths in 3 Harvard Program in Neonatology NICUs between 2005 and 2007. Eligible donors were identified based on criteria developed with our transplantation surgeons and our local organ procurement organization. Potential candidates for DCD were then identified based on an acceptable warm ischemic time.
Of the 192 deaths that occurred during the study period, 161 were excluded, leaving 31 theoretically eligible donors. Of these, 16 patients had a warm ischemic time of <1 hour and were potential candidates for DCD of 14 livers and 18 kidneys, and 14 patients had a warm ischemic time of <30 minutes and were potential candidates for DCD of 10 hearts.
Eight percent of NICU mortalities were potential candidates for DCD. Based on the size of the potential donor pool, establishing an infant DCD protocol for level III NICUs should be considered.
确定在三级新生儿重症监护病房（NICU）环境中死亡的患者中，理论上有资格进行心死亡后捐献（DCD）的比例，以及根据热缺血时间，这些患者中有多少可能成为潜在的 DCD 候选者。
我们对 2005 年至 2007 年期间在哈佛新生儿科三个 NICU 中发生的所有死亡进行了回顾性研究。根据我们的移植外科医生和当地器官获取组织制定的标准，确定了合格的捐献者。然后根据可接受的热缺血时间确定潜在的 DCD 候选者。
在研究期间发生的 192 例死亡中，有 161 例被排除在外，留下 31 例理论上合格的捐献者。在这些患者中，有 16 名患者的热缺血时间<1 小时，是 14 个肝脏和 18 个肾脏的潜在 DCD 候选者，有 14 名患者的热缺血时间<30 分钟，是 10 个心脏的潜在 DCD 候选者。
8%的 NICU 死亡率是潜在的 DCD 候选者。基于潜在供体池的大小，应考虑为三级 NICU 建立婴儿 DCD 方案。
