成年供体器官未移植的预测因素——一项使用欧洲器官移植常规数据的观察性研究
Predictors of non-transplantation of adult donor organs--an observational study using routine data from Eurotransplant.
作者信息
Drewitz Karl Philipp, Loss Martin, Loss Julika, Apfelbacher Christian Joachim
机构信息
Medical Sociology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Dr.-Gessler-Str. 17, 93051, Regensburg, Germany.
Department of Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93051, Regensburg, Germany.
出版信息
BMC Health Serv Res. 2014 Nov 25;14:584. doi: 10.1186/s12913-014-0584-3.
BACKGROUND
The majority of pancreases, offered in allocation, are not transplanted. This pancreas under-utilisation is a phenomenon observed in all transplant systems in North-America and Europe. It was the aim of this study to analyse factors predictive of pancreas non-transplantation in Germany.
METHODS
Routine Eurotransplant data of 3,666 deceased German donors (from 2002-2011) were used for multivariate modelling. Socio-demographic and medical factors were considered as independent variables in logistic regression models with non-transplantation as dependent variable.
RESULTS
Male gender, advanced age, overweight/obesity, long ICU stay, a history of smoking, non-traumatic brain death, elevated levels of sodium, serum glucose, lipase/amylase and the liver not being considered for procurement were significant independent predictors of non-transplantation.
CONCLUSION
In line with previous research, advanced age, high BMI, long ICU stay and the liver not being considered for procurement were the strongest predictors of pancreas non-transplantation in Germany. About three quarters of the variance remained unexplained, suggesting that factors not assessed or unknown may play a decisive role.
背景
分配的大多数胰腺未被移植。胰腺利用不足是在北美和欧洲所有移植系统中都观察到的一种现象。本研究的目的是分析德国胰腺未移植的预测因素。
方法
使用3666名德国已故捐赠者（2002年至2011年）的欧洲移植常规数据进行多变量建模。社会人口统计学和医学因素在以未移植为因变量的逻辑回归模型中被视为自变量。
结果
男性、高龄、超重/肥胖、长时间入住重症监护病房、吸烟史、非创伤性脑死亡、钠、血清葡萄糖、脂肪酶/淀粉酶水平升高以及肝脏未被考虑用于获取是未移植的显著独立预测因素。
结论
与先前的研究一致，高龄、高体重指数、长时间入住重症监护病房以及肝脏未被考虑用于获取是德国胰腺未移植的最强预测因素。约四分之三的变异仍无法解释，这表明未评估或未知的因素可能起决定性作用。
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