Research Department, United Network for Organ Sharing, Richmond, VA.
Policy Department, United Network for Organ Sharing, Richmond, VA.
Transplantation. 2019 May;103(5):990-997. doi: 10.1097/TP.0000000000002457.
Vascularized composite allograft (VCA) transplants include diverse organ types and are made possible primarily by deceased donors.
We used Organ Procurement and Transplantation Network data to characterize VCA deceased donors (n = 66 of 70) in the United States from 1998 to 2017 and compare their characteristics with those of kidney donors in 2017.
Through December 31, 2017, 20 transplant programs performed 72 deceased-donor VCA transplants, with organs donated by 70 donors, including 30 upper limb (17 unilateral and 13 bilateral) and 11 face donors. Other donors donated both upper limbs and face (n = 2), uterus (n = 4), abdominal wall (n = 19), larynx (n = 2), penis (n = 1), and scalp (n = 1). About a third of VCA donors were female, and the majority (86.4%) were white. Almost half (45.5%) were between the ages 18 and 34 years. Smaller proportions were younger than 18 years (19.7%), 35 to 44 years (15.2%), 45 to 54 years (13.6%), and older than 55 years (6.1%). Median body mass index for all VCA donors was 24.9 and varied widely, especially for upper limb and face donors. There was considerable variation in Kidney Donor Profile Index among VCA donors (median, 27.5; interquartile range, 11-59). Donor causes of death included head trauma (39.4%), cerebrovascular/stroke (25.8%), and anoxia (31.8%). VCA donors also donated solid organs that were transplanted, including 87.1% of kidneys, 93.9% of livers, 40.2% of lungs, and 56.1% of hearts.
donors are a demographically and clinically diverse group. Understanding this diversity and future trends in VCA donor characteristics is critical in supporting this life-changing field of transplantation.
带血管复合组织移植物（VCA）移植包括多种器官类型，主要通过已故供体实现。
我们使用器官获取与移植网络数据，对 1998 年至 2017 年间美国的 66 例（70 例中的 66 例）已故 VCA 供体进行特征描述，并将其特征与 2017 年的肾脏供体进行比较。
截至 2017 年 12 月 31 日，20 个移植项目共进行了 72 例已故供体 VCA 移植，器官来自 70 名供体，包括 30 例上肢（17 例单侧和 13 例双侧）和 11 例面部供体。其他供体捐献了上肢和面部（n=2）、子宫（n=4）、腹壁（n=19）、喉（n=2）、阴茎（n=1）和头皮（n=1）。约三分之一的 VCA 供体为女性，多数（86.4%）为白人。近一半（45.5%）年龄在 18 至 34 岁之间。较小比例为 18 岁以下（19.7%）、35 至 44 岁（15.2%）、45 至 54 岁（13.6%）和 55 岁以上（6.1%）。所有 VCA 供体的体重指数中位数为 24.9，差异较大，尤其是上肢和面部供体。VCA 供体的肾脏捐赠者概况指数（KDPI）差异较大（中位数 27.5；四分位距 11-59）。供体死亡原因包括头部创伤（39.4%）、脑血管/中风（25.8%）和缺氧（31.8%）。VCA 供体还捐献了已移植的实体器官，包括 87.1%的肾脏、93.9%的肝脏、40.2%的肺和 56.1%的心脏。
供体是一个具有不同人口统计学和临床特征的群体。了解 VCA 供体特征的这种多样性和未来趋势，对于支持这一改变生命的移植领域至关重要。
