Department of Intensive Care Medicine, The Alfred Hospital, Commercial Road, Prahran, VIC, Australia.
Department of Intensive Care Medicine, St Vincent's Hospital, Victoria Parade, Fitzroy, VIC, Australia.
Transplantation. 2018 Aug;102(8):1323-1329. doi: 10.1097/TP.0000000000002111.
The majority of organ donations in Australia occur in the DonateLife Network of hospitals, but limited monitoring at other sites may allow donation opportunities to be missed. Our aim was to estimate expected donor numbers using routinely collected data from the Australian and New Zealand Intensive Care Society Adult Patient Database and determine whether unrecognized potential donors might exist in non-DonateLife hospitals.
All deaths at 150 Australian intensive care units (ICUs) contributing to the Australian and New Zealand Intensive Care Society Adult Patient Database were analyzed between January 2010 and December 2015. Donor numbers were extracted from the Australian and New Zealand Organ Donor registry. A univariate linear regression model was developed to estimate expected donor numbers in DonateLife hospitals, then applied to non-DonateLife hospitals.
Of 33 614 deaths at 71 DonateLife hospitals, 6835 (20%) met criteria as "ICU deaths potentially suitable to be donors," and 1992 (6%) were actual donors. There was a consistent relationship between these groups (R = 0.626, P < 0.001) allowing the development of a prediction model which adequately estimated expected donors. Of 8077 deaths in 79 non-DonateLife ICUs, 452 (6%) met criteria as potentially suitable donors. Applying the prediction model developed in DonateLife hospitals, the estimated expected donors in non-DonateLife hospitals was 130. However, there were only 75 actual donors.
It is possible to estimate the expected number of Australian organ donors using routinely collected registry data. These findings suggest that there may be a small but significant pool of underutilized potential donors in non-DonateLife hospitals. This may provide an opportunity to increase donation rates.
在澳大利亚，大多数器官捐赠都发生在 DonateLife 网络医院，但在其他地点的监测有限，可能会错过捐赠机会。我们的目的是使用澳大利亚和新西兰重症监护学会成人患者数据库中常规收集的数据来估计预期的捐赠者数量，并确定在非 DonateLife 医院是否存在未被识别的潜在捐赠者。
对 2010 年 1 月至 2015 年 12 月期间向澳大利亚和新西兰重症监护学会成人患者数据库提供数据的 150 家澳大利亚重症监护病房（ICU）的所有死亡病例进行了分析。从澳大利亚和新西兰器官捐赠登记处提取了捐赠者数量。建立了一个单变量线性回归模型来估计 DonateLife 医院的预期捐赠者数量，然后将其应用于非 DonateLife 医院。
在 71 家 DonateLife 医院的 33614 例死亡病例中，有 6835 例（20%）符合“ICU 死亡可能适合成为供体”的标准，1992 例（6%）实际成为了供体。这两组之间存在一致的关系（R=0.626，P<0.001），这使得可以开发一个能够充分估计预期供体的预测模型。在 79 家非 DonateLife ICU 的 8077 例死亡病例中，有 452 例（6%）符合潜在适合供体的标准。应用在 DonateLife 医院建立的预测模型，非 DonateLife 医院的预期捐赠者估计数为 130 例。但实际只有 75 例供体。
使用常规收集的登记数据估算澳大利亚器官捐赠者的预期数量是可行的。这些发现表明，非 DonateLife 医院可能存在一小部分但具有重要意义的未充分利用的潜在供体。这可能提供了提高捐赠率的机会。
