Fayed Mohamed, Pusapati Raju, Widdicombe Neil, Sypek Matthew, Ibrahim Rowaa, Yeldo Nicholas, Penning Donald H
Anesthesiology, Henry Ford Health System, Detroit, USA.
Intensive Care Unit, Queensland Health, Hervey Bay, AUS.
Cureus. 2021 Nov 3;13(11):e19243. doi: 10.7759/cureus.19243. eCollection 2021 Nov.
Background and objective The annual incidence of suicide by hanging in Australia and New Zealand has increased in the past decade, and a significant number of these individuals are becoming organ donors. The rates of organ donation following deaths from hanging is unknown and the characteristics of this cohort of donors have not been described in the literature. In light of this, we aimed to examine the trends in organ donation from individuals who had died from hanging, based on the solid organ donor data from the Australia and New Zealand Organ Donation (ANZOD) Registry. Methods We conducted a retrospective study that analyzed the ANZOD Registry donor data (2006-2015) to describe the characteristics of solid organ donors who had died by hanging (post-hanging group); these characteristics were compared to those of individuals who died by all other causes (non-hanging group). Results During the study period, the number and proportion of donors who died by suicide from hanging increased. Of the 4,024 consented organ donors, 226 had died by hanging and 3,798 had died from other causes. The probability that an individual who died by hanging would become an organ donor increased from 0.5 to 3%. Compared to donors who died by all other causes, post-hanging donors were younger (median age of 30 vs. 50 years), with fewer comorbidities, and a higher incidence of smoking. There was no significant difference in the proportion of those who indicated a prior intent to donate organs between post-hanging (34%) and non-hanging donors (38%). A higher proportion of post-hanging donors donated via the donation after the circulatory death pathway (36.3%) than non-hanging donors (24.2%). Individuals in the post-hanging cohort donated an average of 4.19 organs compared to 3.62 in the non-hanging cohort. Conclusion We believe the findings of this retrospective analysis will help inform clinical decision-making regarding organ donation, including the best approaches to obtaining donation consent. Our findings will help physicians provide care to patients and to families of individuals in this challenging group, where organ donation potential is high. Further investigations are required to determine which aspects of healthcare influence the donation rates in individuals who have died by hanging and the outcomes related to transplanted organs.
背景与目的 在过去十年中,澳大利亚和新西兰上吊自杀的年发生率有所上升,且这些人中有相当一部分成为了器官捐献者。上吊死亡后器官捐献的发生率尚不清楚,且这一捐献者群体的特征在文献中尚未得到描述。有鉴于此,我们旨在根据澳大利亚和新西兰器官捐献(ANZOD)登记处的实体器官捐献者数据,研究上吊死亡者的器官捐献趋势。方法 我们进行了一项回顾性研究,分析了ANZOD登记处的捐献者数据(2006 - 2015年),以描述上吊死亡的实体器官捐献者(上吊后组)的特征;并将这些特征与其他所有原因死亡的个体(非上吊组)进行比较。结果 在研究期间,上吊自杀死亡的捐献者数量和比例有所增加。在4024名同意捐献器官的人中,226人上吊死亡,3798人因其他原因死亡。上吊死亡者成为器官捐献者的概率从0.5%上升至3%。与其他所有原因死亡的捐献者相比,上吊后捐献者更年轻(中位年龄30岁对50岁),合并症更少,吸烟发生率更高。上吊后捐献者(34%)和非上吊捐献者(38%)中表示生前有捐献器官意愿的比例无显著差异。与非上吊捐献者(24.2%)相比,上吊后捐献者通过循环死亡后捐献途径捐献的比例更高(36.3%)。上吊后组个体平均捐献4.19个器官,而非上吊组为3.62个。结论 我们认为这项回顾性分析的结果将有助于为器官捐献的临床决策提供信息,包括获得捐献同意的最佳方法。我们的研究结果将帮助医生为这一具有高器官捐献潜力的挑战性群体中的患者及其家属提供护理。需要进一步调查以确定医疗保健的哪些方面会影响上吊死亡者的捐献率以及与移植器官相关的结果。