Weiss Julius, Elmer Andreas, Béchir Markus, Brunner Christian, Eckert Philippe, Endermann Susann, Lenherr Renato, Nebiker Mathias, Tisljar Kai, Haberthür Christoph, Immer Franz F
Swisstransplant, the Swiss National Foundation for Organ Donation and Transplantation, Bern, Switzerland.
Zentrum für Innere Medizin, Hirslanden Klinik Aarau, Aarau, Switzerland.
BMC Health Serv Res. 2018 Nov 20;18(1):876. doi: 10.1186/s12913-018-3691-8.
Various actions have been taken during the last decade to increase the number of organs from deceased donors available for transplantation in Switzerland. This study provides an overview on key figures of the Swiss deceased organ donation and transplant activity between 2008 and 2017. In addition, it puts the evolution of the Swiss donation program's efficiency in relation to the situation in the neighboring countries.
This study is an analysis of prospective registry data, covering the period from 1 January 2008 to 31 December 2017. It includes all actual deceased organ donors (ADD) in Switzerland. Donor data were extracted from the Swiss Organ Allocation System. The "donor conversion index" (DCI) methodology and data was used for the comparison of donation program efficiency in Switzerland, Germany, Austria, Italy and France.
During the study period there were 1116 ADD in Switzerland. The number of ADD per year increased from 91 in 2008 to 145 in 2017 (+ 59%). The reintroduction of the donation after cardiocirculatory death (DCD) program in 2011 resulted in the growth of annual percentages of DCD donors, reaching a maximum of 27% in 2017. The total number of organs transplanted from ADD was 3763 (3.4 ± 1.5 transplants per donor on average). Of these, 48% were kidneys (n = 1814), 24% livers (n = 903), 12% lungs (n = 445), 9% hearts (n = 352) and 7% pancreata or pancreatic islets (n = 249). The donation program efficiency assessment showed an increase of the Swiss DCI from 1.6% in 2008 to 2.7% in 2017 (+ 69%). The most prominent efficiency growth was observed between 2012 and 2017. Even though Swiss donation efficiency increased during the study period, it remained below the DCI of the French and Austrian donation programs.
Swiss donation activity and efficiency grew during the last decade. The increased donation efficiency suggests that measures implemented so far were effective. The lower efficiency of the Swiss donation program, compared to the French and Austrian programs, may likely be explained by the lower consent rate in Switzerland. This issue should be addressed in order to achieve the goal of more organs available for transplantation.
在过去十年中，瑞士采取了各种行动，以增加可用于移植的已故捐赠者器官数量。本研究概述了2008年至2017年瑞士已故器官捐赠和移植活动的关键数据。此外，还将瑞士捐赠计划效率的演变与邻国的情况进行了对比。
本研究对2008年1月1日至2017年12月31日期间的前瞻性登记数据进行了分析。研究对象包括瑞士所有实际的已故器官捐赠者（ADD）。捐赠者数据从瑞士器官分配系统中提取。采用“捐赠者转换指数”（DCI）方法和数据，对瑞士、德国、奥地利、意大利和法国的捐赠计划效率进行比较。
在研究期间，瑞士有1116名ADD。每年的ADD数量从2008年的91例增加到2017年的145例（增长59%）。2011年重新引入心脏循环死亡后捐赠（DCD）计划，导致DCD捐赠者的年度百分比增长，2017年达到最高的27%。从ADD移植的器官总数为3763个（平均每位捐赠者移植3.4±1.5个器官）。其中，48%为肾脏（n = 1814），24%为肝脏（n = 903），12%为肺（n = 445），9%为心脏（n = 352），7%为胰腺或胰岛（n = 249）。捐赠计划效率评估显示，瑞士的DCI从2008年的1.6%提高到2017年的2.7%（增长69%）。2012年至2017年期间观察到最显著的效率增长。尽管在研究期间瑞士的捐赠效率有所提高，但仍低于法国和奥地利捐赠计划的DCI。
在过去十年中，瑞士的捐赠活动和效率有所增长。捐赠效率的提高表明迄今实施的措施是有效的。与法国和奥地利的计划相比，瑞士捐赠计划效率较低，可能是因为瑞士的同意率较低。为了实现有更多器官可用于移植的目标，应解决这一问题。
