Intensive Care Unit and Regional ECMO Referral centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
Hepatobiliary Surgery and Liver Transplantation Unit, University of Pisa Medical School Hospital, Pisa, Italy.
Clin Transplant. 2020 Aug;34(8):e13896. doi: 10.1111/ctr.13896. Epub 2020 Jun 3.
Effectiveness of uncontrolled donation after circulatory death (uDCD) has been recently reported to be 75% according to data coming from some European countries in 2016, but few data are to date available on this topic.
We assessed the utilization rate (as the percentage of donors who were converted into actual donors) in 37 uDCDs consecutively enrolled at our Center (Careggi Teaching Hospital) from June 2016 to June 2019.
In three cases, the family did not give consent for donation (3/37, 8.1%). Among the 37 potential uDCDs, 22 became actual donors (22/37, 59%), with 10 livers and 38 kidneys being transplanted, respectively. Fifteen livers were recovered (15/37, 68%), and 10 livers were transplanted (10/15, 67%). Forty-two kidneys were procured and 38 organs transplanted. The overall effectiveness was 78%.
According to our 3-year experience, uncontrolled DCDs do represent an additional means of increasing the number of transplanted organs (kidneys and livers) with an acceptable utilization rate. Research on organ viability assessment (for both livers and kidneys from uDCDs) is still in its infancy, and there is probably space for a further wider use of organs from uDCDs.
据 2016 年一些欧洲国家的数据显示,循环死亡后未控制供体(uDCD)的有效性为 75%,但迄今为止,关于这一主题的数据很少。
我们评估了 2016 年 6 月至 2019 年 6 月在我们中心(卡雷吉教学医院)连续纳入的 37 例 uDCD 的利用率(即转化为实际供体的供体百分比)。
在 3 例中,家属不同意捐献(3/37,8.1%)。在 37 例潜在 uDCD 中,有 22 例成为实际供体(22/37,59%),分别进行了 10 例肝脏和 38 例肾脏移植。分别回收了 15 个肝脏(15/37,68%),并进行了 10 例肝脏移植(10/15,67%)。共获取 42 个肾脏,移植 38 个器官。整体有效率为 78%。
根据我们 3 年的经验,未控制的 DCD 确实代表了增加移植器官(肾脏和肝脏)数量的另一种手段,其利用率可接受。关于器官活力评估(包括来自 uDCD 的肝脏和肾脏)的研究仍处于起步阶段,可能还有进一步更广泛使用 uDCD 器官的空间。