Twamley Huw, Haigh Andrew, Williment Claire, Hudson Cara, Whitney Julie, Neuberger James
Consultant in Anaesthesia and Critical Care, Royal Preston Hospital, Preston, UK.
Coroner's Court, Stafford, UK.
BMJ Open. 2016 Jul 8;6(7):e010231. doi: 10.1136/bmjopen-2015-010231.
Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process.
Prospective audit.
All acute National Health Service Hospitals in the UK where deceased organ donation was considered.
1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF.
Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice.
Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant.
Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants.
轶事证据表明，如果所有情况都遵循最佳实践，那么提交给验尸官/地方检察官（PF）的已故捐赠者的器官捐赠数量可能会增加。这项前瞻性审计的目的是确定转诊如何影响器官捐赠，并制定基于证据的指南，以确保在不干扰验尸官/PF调查过程的情况下安全地促进器官捐赠。
前瞻性审计。
英国所有考虑进行已故器官捐赠的国民保健服务急性医院。
1437名符合器官捐赠资格标准并被提交给验尸官/PF的已故患者。
给予移植许可的病例数、拒绝许可的器官数以及如果所有人都遵循最佳实践可能进行移植的器官数。
87%的病例获得了完全的器官获取许可，9%获得了部分许可。然而，如果在未进行尸检或限制似乎不合理的情况下给予完全许可，那么多达77个器官（22个肺、22个肾脏、9个胰腺、9个肝脏、8个心脏和7个小肠）本可用于移植。
验尸官/PF及其工作人员对移植表现出强烈支持，但实践中的改进可能会使挽救生命和改善生活的移植数量有小幅但显著的增加。
