Division of Critical Medicine, Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, WI, USA.
Division of Critical Care, Department of Pediatrics, Medical College of Wisconsin and Children's Wisconsin, Milwaukee, WI, USA.
Pediatr Transplant. 2021 May;25(3):e13926. doi: 10.1111/petr.13926. Epub 2020 Dec 16.
In pediatrics, an increasing need for transplantable organs exists. This study aimed to describe the epidemiology of pediatric deceased donors in the United States. This retrospective observational study utilized data from the Organ Procurement and Transplantation Network (OPTN) from 2000 to 2015. Patients were stratified based on method of organ donation. Demographic variables and mechanism of death were then compared. A total of 14,481 deceased pediatric organ donors, donation after brain death (DBD) and donation after circulatory death (DCD), were included in the study, of which 8% were DCD donors. A significant difference (p<0.001) existed between the two donor groups with respect to ethnicity and mechanism of death. The annual trend of DCD and DBD donors showed an inverse relationship. During the 15-year study period the number of DBD donors decreased from 985 to 785 per year while DCD donors increased from 15 to 146 per year. As well, overall organs transplanted per year decreased from 3,475 to 3,117 over the 15-year study period. Significant differences exist between pediatric DBD donors and DCD donors, specifically with respect to ethnicity and mechanism of death. The number of pediatric DBD donors is decreasing while the number of pediatric DCD is slowly rising, making it increasingly important to be able to characterize these donors to better identify eligible DCD donors to optimize organ utilization.
在儿科领域,对可移植器官的需求不断增加。本研究旨在描述美国儿科已故供者的流行病学。本回顾性观察研究利用了 2000 年至 2015 年期间器官获取和移植网络(OPTN)的数据。根据器官捐献方式对患者进行分层,然后比较人口统计学变量和死亡机制。本研究共纳入 14481 名已故儿科器官捐献者,其中包括脑死亡后捐献(DBD)和循环死亡后捐献(DCD),分别占 8%。两个供者组在种族和死亡机制方面存在显著差异(p<0.001)。DCD 和 DBD 供者的年度趋势呈反比关系。在 15 年的研究期间,DBD 供者的数量从每年 985 人减少到 785 人,而 DCD 供者的数量从每年 15 人增加到 146 人。此外,在 15 年的研究期间,每年移植的器官总数从 3475 个减少到 3117 个。儿科 DBD 供者和 DCD 供者之间存在显著差异,特别是在种族和死亡机制方面。儿科 DBD 供者的数量正在减少,而儿科 DCD 供者的数量正在缓慢增加,因此能够对这些供者进行特征描述以更好地确定合格的 DCD 供者,从而优化器官利用变得越来越重要。