Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Data Science and Biostatistics Unit, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Am J Transplant. 2024 Jun;24(6):983-992. doi: 10.1016/j.ajt.2024.02.007. Epub 2024 Feb 10.
Some United States organ procurement organizations transfer deceased organ donors to donor care units (DCUs) for recovery procedures. We used Organ Procurement and Transplantation Network data, from April 2017 to June 2021, to describe the proximity of adult deceased donors after brain death to DCUs and understand the impact of donor service area (DSA) boundaries on transfer efficiency. Among 19 109 donors (56.1% of the cohort) in 25 DSAs with DCUs, a majority (14 593 [76.4%]) were in hospitals within a 2-hour drive. In areas with DCUs detectable in the study data set, a minority of donors (3582 of 11 532 [31.1%]) were transferred to a DCU; transfer rates varied between DSAs (median, 27.7%, range, 4.0%-96.5%). Median hospital-to-DCU driving times were not meaningfully shorter among transferred donors (50 vs 51 minutes for not transferred, P < .001). When DSA boundaries were ignored, 3241 cohort donors (9.5%) without current DCU access were managed in hospitals within 2 hours of a DCU and thus potentially eligible for transfer. In summary, approximately half of United States deceased donors after brain death are managed in hospitals in DSAs with a DCU. Transfer of donors between DSAs may increase DCU utilization and improve system efficiency.
一些美国器官获取组织将脑死亡的已故器官捐献者转移到供体护理单元 (DCU) 进行复苏程序。我们使用了器官获取和移植网络的数据（2017 年 4 月至 2021 年 6 月），描述了脑死亡后成年已故捐献者与 DCU 的接近程度，并了解了供体服务区 (DSA) 边界对转移效率的影响。在 25 个设有 DCU 的 DSA 中，有 19109 名供者（队列的 56.1%），其中大多数（14593 名[76.4%]）在 2 小时车程内的医院。在设有 DCU 的研究数据集可检测到的区域，少数供者（11532 名中的 3582 名[31.1%]）被转移到 DCU；转移率在 DSA 之间有所不同（中位数，27.7%，范围，4.0%-96.5%）。转移供者的医院到 DCU 的驾驶时间中位数没有明显缩短（转移的为 50 分钟，未转移的为 51 分钟，P<0.001）。当忽略 DSA 边界时，没有当前 DCU 通道的 3241 名队列供者（9.5%）在距离 DCU 2 小时内的医院中得到管理，因此可能有资格进行转移。总之，大约一半的脑死亡后美国已故供者在设有 DCU 的 DSA 中的医院中得到管理。在 DSA 之间转移供者可能会增加 DCU 的利用率并提高系统效率。
