Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Am J Transplant. 2011 Jul;11(7):1517-21. doi: 10.1111/j.1600-6143.2011.03485.x. Epub 2011 Mar 30.
The disparity between the number of patients in need of organ transplantation and the number of available organs is steadily rising. We hypothesized that intensivist-led management of brain dead donors would increase the number of organs recovered for transplantation. We retrospectively analyzed data from all consented adult brain dead patients in the year before (n = 35) and after (n = 43) implementation of an intensivist-led donor management program. Donor characteristics before and after implementation were similar. After implementation of the organ donor support team, the overall number of organs recovered for transplantation increased significantly (66 out of 210 potentially available organs vs. 113 out of 258 potentially available organs, p = 0.008). This was largely due to an increase in the number of lungs (8 out of 70 potentially available lungs vs. 21 out of 86 potentially available lungs; p = 0.039) and kidneys (31 out of 70 potentially available kidneys vs. 52 out of 86 potentially available kidneys; p = 0.044) recovered for transplantation. The number of hearts and livers recovered for transplantation did not change significantly. Institution of an intensivist-led organ donor support team may be a new and viable strategy to increase the number of organs available for transplantations.
器官移植需求患者数量与可供器官数量之间的差距正在稳步扩大。我们假设,由重症监护医生主导管理脑死亡供者将增加可用于移植的器官数量。我们回顾性分析了在实施由重症监护医生主导的供者管理方案之前(n=35)和之后(n=43)所有同意的成年脑死亡患者的数据。实施方案前后供者特征相似。在器官捐献支持团队实施后,可用于移植的器官总数显著增加(210 个潜在可用器官中有 66 个 vs. 258 个潜在可用器官中有 113 个,p=0.008)。这主要是由于可用于移植的肺(70 个潜在可用肺中有 8 个 vs. 86 个潜在可用肺中有 21 个;p=0.039)和肾脏(70 个潜在可用肾脏中有 31 个 vs. 86 个潜在可用肾脏中有 52 个;p=0.044)数量增加所致。可用于移植的心脏和肝脏数量没有显著变化。建立由重症监护医生主导的器官捐献支持团队可能是增加可用于移植的器官数量的一种新的可行策略。