Han Sang Youb, Kim Jae Il, Lee Eun-Woo, Jang Hye-Yeon, Han Kum Hyun, Oh Se Won, Roh Young-Nam
Department of Nephrology, Inje University, College of Medicine, Ilsan Paik Hospital, Goyang, South Korea.
Department of Surgery, Inje University, College of Medicine, Ilsan Paik Hospital, Goyang, South Korea.
Ann Transplant. 2017 Jan 17;22:17-23. doi: 10.12659/aot.901616.
BACKGROUND This study aimed to explore the factors associated with a family's delay of decision for organ donation after brain death, and to investigate the effect of such a delay on organ donation. MATERIAL AND METHODS Medical records and data on counseling about organ donation with the families of 107 brain-dead potential donors between September 2012 and March 2016 at a single tertiary medical center were retrospectively reviewed. RESULTS The final consent rate was 58% (62/107), and successful donation was performed in 40% (43/107). Ninety-two families (86%) made a decision within 48 hours, whereas 15 (14%) required more than 48 hours for a final decision. In univariate and multivariate analyses, the independent factors associated with a decision delay were mean arterial pressure ≤60 mm Hg and coma therapy. In the early decision group (<48 hours), the consent and successful donation rates were 55% (51/92) and 39% (36/92), respectively, whereas in the delayed decision group (≥48 hours), these rates were 73% (11/15) and 47% (7/15), respectively. The consent and successful donation rates were not inferior in the delayed decision group. CONCLUSIONS These findings justify continuous efforts to maintain organ viability and to extend counseling to encourage donation even if the family cannot decide immediately.
背景 本研究旨在探讨与脑死亡后家庭延迟做出器官捐赠决定相关的因素,并调查这种延迟对器官捐赠的影响。
材料与方法 回顾性分析了2012年9月至2016年3月期间在一家三级医疗中心的107名脑死亡潜在捐赠者家庭的医疗记录及器官捐赠咨询数据。
结果 最终同意率为58%(62/107),成功捐赠率为40%(43/107)。92个家庭(86%)在48小时内做出了决定,而15个家庭(14%)需要超过48小时才能做出最终决定。在单因素和多因素分析中,与决定延迟相关的独立因素是平均动脉压≤60 mmHg和昏迷治疗。在早期决定组(<48小时)中,同意率和成功捐赠率分别为55%(51/92)和39%(36/92),而在延迟决定组(≥48小时)中,这些比率分别为73%(11/15)和47%(7/15)。延迟决定组的同意率和成功捐赠率并不低。
结论 这些发现证明,即使家庭不能立即做出决定,也有必要持续努力维持器官的活力,并延长咨询以鼓励捐赠。