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了解哥伦比亚已故器官捐赠与利用的动态情况。

Understanding the dynamics of deceased organ donation and utilization in Colombia.

作者信息

Cruz Mususú William, García-Lopez Andrea, Lozano-Suarez Nicolás, Gómez-Montero Andrea, Orellano-Salas Milena, Vargas-Pérez Luisa, Escobar-Chaves Ximena, Girón-Luque Fernando

机构信息

Fundonar Colombia Bogotá Colombia Fundonar Colombia, Bogotá, Colombia.

Colombiana de Trasplantes Bogotá Colombia Colombiana de Trasplantes, Bogotá, Colombia.

出版信息

Rev Panam Salud Publica. 2024 Mar 8;48:e24. doi: 10.26633/RPSP.2024.24. eCollection 2024.

Abstract

OBJECTIVE

To obtain a comprehensive overview of organ donation, organ utilization, and discard in the entire donation process in Colombia.

METHODS

A retrospective study of 1 451 possible donors, distributed in three regions of Colombia, evaluated in 2022. The general characteristics, diagnosis, and causes of contraindication for potential donors were described.

RESULTS

Among the 1 451 possible donors, 441 (30.4%) fulfilled brain death criteria, constituting the potential dono pool. Families consented to organ donation in 141 medically suitable cases, while 60 instances utilized legal presumption, leading to 201 eligible donors (13.9%). Of those, 160 (11.0%) were actual donors (in whom operative incision was made with the intent of organ recovery or who had at least one organ recovered). Finally, we identified 147 utilized donors (10.1%) (from whom at least one organ was transplanted). Statistically significant differences were found between age, sex, diagnosis of brain death, and donor critical pathway between regions. A total of 411 organs were transplanted from 147 utilized donors, with kidneys being the most frequently procured and transplanted organs, accounting for 280 (68.1%) of the total. This was followed by 85 livers (20.7%), 31 hearts (7.5%), 14 lungs (3.4%), and 1 pancreas (0.2%). The discard rate of procured deceased donors was 8.1%.

CONCLUSIONS

About one-tenth of donors are effectively used for transplantation purposes. Our findings highlight areas of success and challenges, providing a basis for future improvements in Colombia.

摘要

目的

全面了解哥伦比亚整个捐赠过程中的器官捐赠、器官利用及废弃情况。

方法

对2022年在哥伦比亚三个地区评估的1451名潜在捐赠者进行回顾性研究。描述了潜在捐赠者的一般特征、诊断及禁忌原因。

结果

在1451名潜在捐赠者中,441名(30.4%)符合脑死亡标准,构成潜在捐赠者库。在141例医学上合适的病例中,家属同意器官捐赠,而60例利用法律推定,从而产生了201名合格捐赠者(13.9%)。其中,160名(11.0%)为实际捐赠者(即有意为器官获取而进行手术切口或至少有一个器官被获取的人)。最后,我们确定了147名被利用的捐赠者(10.1%)(至少有一个器官被移植)。各地区在年龄、性别、脑死亡诊断及捐赠者关键路径方面存在统计学显著差异。从147名被利用的捐赠者中共移植了411个器官,肾脏是获取和移植最频繁的器官,占总数的280个(68.1%)。其次是85个肝脏(20.7%)、31个心脏(7.5%)、14个肺(3.4%)和1个胰腺(0.2%)。获取的已故捐赠者的废弃率为8.1%。

结论

约十分之一的捐赠者被有效用于移植目的。我们的研究结果突出了成功和挑战领域,为哥伦比亚未来的改进提供了依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61bd/10921909/2e11d451335a/rpsp-48-e24_Figure1.jpg

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