d'Aranda Erwan, Arsonneau Valérie, Demory Didier
Sainte Anne Military Teaching Hospital, Intensive Care Unit, Toulon, France.
CHITS Sainte-Musse Hospital, Local Organ Procurement Organization, Toulon, France.
Turk J Anaesthesiol Reanim. 2024 Dec 16;52(6):207-212. doi: 10.4274/TJAR.2024.241676.
Deficiency of organs for transplantation is a significant public health issue. French learned societies accept intensive care unit admission for patients with catastrophic neurological prognosis to optimize organs prior to probable brain death. We evaluated the implementation of a specific ethical care procedure for these patients.
A descriptive before-after study was conducted, comparing the 2009-2012 period to the 2013-2016 period, during which this procedure was applied.
The number of patients increased from 145 to 186 (+28.3%) and the number of harvested organs increased from 323 to 485 (+50.1%). The anticipated organ donation approach was initiated 135 times. Of the 117 meetings with families, 83 (71%) consented to organ donation. Fifty-three (64%) patients were brain dead, and 49 (92%) of these patients had 194 organs harvested.
The anticipated approach increased the number of donors and organs suitable for grafts. The application of a specific protocol for managing untreatable catastrophic neurological patients improved communication between hospital staff and families and respected patient autonomy by offering options for either organ donation or palliative care.
可供移植的器官短缺是一个重大的公共卫生问题。法国各学术团体同意收治神经预后灾难性的患者入住重症监护病房，以便在可能发生脑死亡之前优化器官。我们评估了针对这些患者实施的特定伦理护理程序。
进行了一项前后对比描述性研究，比较了2009 - 2012年期间和2013 - 2016年期间（此程序实施期间）的情况。
患者数量从145例增加到186例（增加28.3%），获取的器官数量从323个增加到485个（增加50.1%）。预期器官捐赠方法启动了135次。在与家属的117次会面中，83例（71%）同意器官捐赠。53例（64%）患者发生脑死亡，其中49例（92%）患者的194个器官被获取。
预期方法增加了供体数量和适合移植的器官数量。针对无法治疗的灾难性神经疾病患者实施特定方案，改善了医院工作人员与家属之间的沟通，并通过提供器官捐赠或姑息治疗的选择尊重了患者自主权。
