Nelson Helen M, Glazier Alexandra K, Delmonico Francis L
1 New England Organ Bank, Boston, MA.
Transplantation. 2016 Feb;100(2):446-50. doi: 10.1097/TP.0000000000000954.
The clinical characteristics of all New England Organ Bank (NEOB) donors after circulatory death (DCD) donors were analyzed between July 1, 2009, and June 30, 2014. During that 5-year period, there were 494 authorized medically suitable potential DCDs that the NEOB evaluated, constituting more than 30% of deceased donors coordinated annually by the NEOB. From the cohort of 494 authorized potential DCDs, 331 (67%) became actual DCD, 82 (17%) were attempted as a DCD but did not progress to donation, and 81 (16%) transitioned to an actual donor after brain death (DBD). Two hundred seventy-six organs were transplanted from the 81 donors that transitioned from DCD to actual DBD, including 24 heart, 70 liver, 12 single and 14 bilateral lung, and 12 pancreas transplants. When patients with devastating brain injury admitted to the intensive care units are registered donors, the Organ Procurement Organization staff should share the patient's donation decision with the health care team and the patient's family, as early as possible after the comfort measures only discussion has been initiated. The experience of the NEOB becomes an important reference of the successful implementation of DCD that enables an expansion of deceased donation (inclusive of DBD).
对2009年7月1日至2014年6月30日期间新英格兰器官银行（NEOB）所有循环死亡（DCD）供体的临床特征进行了分析。在这5年期间，NEOB评估了494名经授权的医学上合适的潜在DCD供体，占NEOB每年协调的已故供体的30%以上。在494名经授权的潜在DCD供体队列中，331名（67%）成为实际DCD供体，82名（17%）尝试进行DCD供体操作但未进展到捐献，81名（16%）在脑死亡（DBD）后转变为实际供体。从81名从DCD转变为实际DBD的供体中移植了276个器官，包括24例心脏、70例肝脏、12例单肺和14例双肺以及12例胰腺移植。当入住重症监护病房的严重脑损伤患者登记为供体时，器官获取组织工作人员应在仅开始讨论舒适措施后尽早与医疗团队和患者家属分享患者的捐献决定。NEOB的经验成为成功实施DCD的重要参考，有助于扩大已故捐献（包括DBD）。
