Ismail Abdul Jabbar Bin, Ahmad Nor Diyanah, Ching Chong Si, Lean Cheah Siew, Keong Tony Tan Beng, Zaini Mohd Izzwan, Kheng Cheah Phee
Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
Department of Anaesthesiology and Intensive Care, Hospital Sultanah Aminah, Johor Bahru, Malaysia.
Korean J Transplant. 2023 Jun 30;37(2):85-94. doi: 10.4285/kjt.23.0009. Epub 2023 Apr 24.
Improving organ donation rates requires better detection of possible organ donors, which in turn necessitates identifying barriers preventing the identification of possible organ donors. The objectives of this study were to determine the actual rate of possible deceased organ donors among nonreferred cases and to identify barriers to their identification as possible donors.
This retrospective observational study used 6 months of data collected from two intensive care units (ICUs). Possible organ donors were defined as patients with a Glasgow Coma Scale score <5 and evidence of severe neurological damage. Barriers that led to the nonidentification of these patients as possible organ donors were also identified.
Fifty-six of 819 patients admitted to the ICUs during the study period were detected as possible organ donors, representing a 6.83% possible organ donor detection rate. Nonclinical barriers to the identification of possible organ donors were found to be more significant than clinical barriers (55% vs. 45%, respectively). The most significant nonclinical barrier was an unknown reason, despite patients being medically suitable for deceased organ donation and fulfilling the criteria for possible organ donor classification. Unresolved sepsis was the main clinical barrier.
The significant rate of unreferred possible deceased organ donors found in this study reveals the need to increase awareness and knowledge among clinicians of the proper detection of possible donors at an early stage to avoid the loss of possible deceased organ donors, and thereby increase the deceased organ donation rate in Malaysian hospitals.
提高器官捐献率需要更好地检测潜在器官捐献者，而这又需要识别阻碍潜在器官捐献者识别的障碍。本研究的目的是确定未被转诊病例中潜在的已故器官捐献者的实际比例，并识别将他们识别为潜在捐献者的障碍。
这项回顾性观察研究使用了从两个重症监护病房（ICU）收集的6个月数据。潜在器官捐献者被定义为格拉斯哥昏迷量表评分＜5且有严重神经损伤证据的患者。还识别了导致这些患者未被识别为潜在器官捐献者的障碍。
在研究期间入住ICU的819名患者中，有56名被检测为潜在器官捐献者，潜在器官捐献者检测率为6.83%。发现识别潜在器官捐献者的非临床障碍比临床障碍更显著（分别为55%和45%）。最显著的非临床障碍是原因不明，尽管患者在医学上适合已故器官捐献且符合潜在器官捐献者分类标准。未解决的脓毒症是主要的临床障碍。
本研究中发现的未被转诊的潜在已故器官捐献者的比例很高，这表明有必要提高临床医生对早期正确检测潜在捐献者的认识和知识，以避免潜在已故器官捐献者的流失，从而提高马来西亚医院的已故器官捐献率。
