Lomero Mar, Gardiner Dale, Coll Elisabeth, Haase-Kromwijk Bernadette, Procaccio Francesco, Immer Franz, Gabbasova Lyalya, Antoine Corine, Jushinskis Janis, Lynch Nessa, Foss Stein, Bolotinha Catarina, Ashkenazi Tamar, Colenbie Luc, Zuckermann Andreas, Adamec Miloš, Czerwiński Jarosław, Karčiauskaitė Sonata, Ström Helena, López-Fraga Marta, Dominguez-Gil Beatriz
European Directorate for the Quality of Medicines & Healthcare/Council of Europe, Strasbourg, France.
National Clinical Lead for Organ Donation, NHS Blood and Transplant, Watford, UK.
Transpl Int. 2020 Jan;33(1):76-88. doi: 10.1111/tri.13506. Epub 2019 Oct 7.
Donation after circulatory death (DCD) has become an accepted practice in many countries and remains a focus of intense interest in the transplant community. The present study is aimed at providing a description of the current situation of DCD in European countries. Specific questionnaires were developed to compile information on DCD practices, activities and post-transplant outcomes. Thirty-five countries completed the survey. DCD is practiced in 18 countries: eight have both controlled DCD (cDCD) and uncontrolled DCD (uDCD) programs, 4 only cDCD and 6 only uDCD. All these countries have legally binding and/or nonbinding texts to regulate the practice of DCD. The no-touch period ranges from 5 to 30 min. There are variations in ante and post mortem interventions used for the practice of cDCD. During 2008-2016, the highest DCD activity was described in the United Kingdom, Spain, Russia, the Netherlands, Belgium and France. Data on post-transplant outcomes of patients who receive DCD donor kidneys show better results with grafts obtained from cDCD versus uDCD donors. In conclusion, DCD is becoming increasingly accepted and performed in Europe, importantly contributing to the number of organs available and providing acceptable post-transplantation outcomes.
心脏死亡后器官捐献（DCD）在许多国家已成为一种被认可的做法，并且仍然是移植界密切关注的焦点。本研究旨在描述欧洲国家DCD的现状。我们设计了特定的问卷，以收集有关DCD实践、活动及移植后结果的信息。35个国家完成了调查。18个国家开展了DCD：8个国家既有控制性DCD（cDCD）项目，也有非控制性DCD（uDCD）项目；4个国家只有cDCD项目；6个国家只有uDCD项目。所有这些国家都有具有法律约束力和/或无法律约束力的文本，以规范DCD的实践。无接触期为5至30分钟。在cDCD实践中，生前和死后干预措施存在差异。在2008年至2016年期间，英国、西班牙、俄罗斯、荷兰、比利时和法国的DCD活动最为活跃。接受DCD供体肾脏的患者移植后结果数据显示，与uDCD供体的移植物相比，cDCD供体的移植物效果更好。总之，DCD在欧洲越来越被接受和实施，对可用器官数量有重要贡献，并提供了可接受的移植后结果。
