Hofmann Nicola, Wittmershaus Ilka, Salz Anna-Katharina, Börgel Martin
German Society for Tissue Transplantation (DGFG) gGmbH, Hannover, Germany.
Transfus Med Hemother. 2021 Feb;48(1):3-11. doi: 10.1159/000510588. Epub 2020 Oct 8.
The realization of tissue donations is bound to a tight timeframe. Depending on the type of tissue, time limits are specified within which the donation must be procured and processed. Otherwise, there is a risk of tissue quality loss with increasing time intervals from cardiovascular arrest. According to the European Directorate for the Quality of Medicines and HealthCare (EDQM) guide, cornea must be procured and processed within 72 h after death. The question arises whether this time interval has an influence on the quality of transplanted tissues and how it affects the accomplishment of tissue donations.
In order to obtain information on this, the numbers of tissue donations in the network of the German Society for Tissue Transplantation (DGFG) were evaluated as a function of the death to retrieval time (DRT) as well as the death to preservation time (DPT). For this purpose, 21,454 database entries of cornea donations made in the period from 2014 to 2018 were included.
The results show that nearly 50% of donations realized in the DGFG network could be processed only 48 h or later after cardiovascular death due to the opt-in regulation in Germany. For these donations, there seems to be a higher discard rate compared to donations taken earlier. Nevertheless, there is a transplantation rate for these grafts of more than 65%, which is comparable to average transplantation rates stated in the literature.
All corneas finally selected for transplantation must meet the specified quality parameters. Since this naturally also applies to transplants that could only be procured at later time points, it can be concluded that DPT up to 72 h for corneal tissue is adequate and has no influence on the quality of corneas that are ultimately transplanted.
组织捐赠的实现必然受到严格的时间限制。根据组织类型的不同,规定了必须获取和处理捐赠组织的时间限制。否则,随着与心脏骤停时间间隔的增加,存在组织质量下降的风险。根据欧洲药品和医疗保健质量管理局(EDQM)指南,角膜必须在死亡后72小时内获取和处理。问题在于这个时间间隔是否会对移植组织的质量产生影响,以及它如何影响组织捐赠的完成情况。
为了获取相关信息,对德国组织移植协会(DGFG)网络中的组织捐赠数量进行了评估,评估指标为死亡至取回时间(DRT)以及死亡至保存时间(DPT)。为此,纳入了2014年至2018年期间21454条角膜捐赠的数据库记录。
结果表明,由于德国的选择加入规定,DGFG网络中近50%的捐赠在心脏死亡后48小时或更晚才能进行处理。与较早进行的捐赠相比,这些捐赠的丢弃率似乎更高。然而,这些移植物的移植率超过65%,与文献中所述的平均移植率相当。
所有最终被选中用于移植的角膜必须符合规定的质量参数。由于这自然也适用于只能在较晚时间点获取的移植组织,可以得出结论,角膜组织的DPT长达72小时是足够的,并且对最终移植的角膜质量没有影响。