Division of Transplant, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Am J Transplant. 2018 Feb;18(2):492-503. doi: 10.1111/ajt.14536. Epub 2017 Nov 21.
Organ shortage continues to challenge the field of transplantation. One potential group of donors are those who have been transplant recipients themselves, or Organ Donation After Transplant (ODAT) donors. We conducted a retrospective cohort study to describe ODAT donors and to compare outcomes of ODAT grafts versus conventional grafts. From October 1, 1987 to June 30, 2015, 517 former recipients successfully donated 803 organs for transplant. Former kidney recipients generally survived a median of approximately 4 years before becoming an ODAT donor whereas liver, lung, and heart recipients generally survived less than a month prior to donation. In the period June 1, 2005 to December 31, 2014, liver grafts from ODAT donors had a significantly higher risk of graft failure compared to non-ODAT liver transplants (P = .008). Kidney grafts donated by ODAT donors whose initial transplant occurred >1 year prior were associated with significantly increased graft failure (P = .012). Despite increased risk of graft failure amongst certain ODAT grafts, 5-year survival was still high. ODAT donors should be considered another form of expanded criteria donor under these circumstances.
器官短缺继续对移植领域构成挑战。一类潜在的供体是那些自身已经接受过器官移植的人，或称为移植后器官捐献者（ODAT）。我们进行了一项回顾性队列研究，旨在描述 ODAT 捐献者，并比较 ODAT 移植物与传统移植物的结局。1987 年 10 月 1 日至 2015 年 6 月 30 日，517 名曾经的受者成功捐献了 803 个器官用于移植。曾经接受过肾脏移植的受者通常在成为 ODAT 供体之前存活了大约 4 年，而接受肝脏、肺和心脏移植的受者在捐献前通常存活不到一个月。在 2005 年 6 月 1 日至 2014 年 12 月 31 日期间，ODAT 供体的肝脏移植物与非 ODAT 肝移植相比，发生移植物失功的风险显著更高（P =.008）。ODAT 供体捐献的肾脏移植物，其初始移植发生在 1 年以上的，与显著增加的移植物失功相关（P =.012）。尽管某些 ODAT 移植物发生移植物失功的风险增加，但 5 年生存率仍然很高。在这种情况下，ODAT 供体应被视为另一种形式的扩展标准供体。
