Lehmann Felix, Ehrentraut Stefan F, Görtzen-Patin Jan, Söhle Martin, Langer Juliane, Banat Mohammed, Schrader Daniel, Kraus Holger, Weller Johannes
Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
Klinik für Innere Medizin I, Universitätsklinikum Bonn, Bonn, Deutschland.
Med Klin Intensivmed Notfmed. 2025 Jan 28. doi: 10.1007/s00063-024-01237-6.
The persistently low number of postmortem organ donations in Germany has repeatedly led to political discussions and most recently to the amendment of the Transplantation Act with the strengthening of the role of the transplantation officer and the introduction of a register to document the will to donate. The background to these decisions was the assumption that a relevant proportion of potential organ donors in hospitals were being overlooked and not reported. However, due to the lack of guidelines as to when a potential organ donor must be reported to the DSO ("Deutsche Stiftung Organspende"), the existing data is only of limited validity.
The transplantation officers of the university hospitals in North Rhine-Westphalia (NRW) therefore agreed on the HEW score (brain function loss-suitability-will) presented here as a shared standard for reporting potential organ donors.
Assigning the scores from 1 to 3 to each of the three included attributes results in a score of 111 to 333, and reporting to the DSO is recommended if the threshold value of 213 is exceeded. For implementation, the HEW scores of the cases determined by TransplantCheck from the university hospitals in Bonn, Essen and Düsseldorf from 2022 were collected retrospectively and presented in this paper.
Overall, the number of cases to be reported according to the HEW score was 13.5% below the number of cases actually reported at all three sites (126 vs. 109). In all three centres, the refusal rate was high at 54.5-64.9%.
The HEW score represents a tool for the detailed recording and standardised reporting of potential organ donors and can enable homogenised reporting behaviour as a data basis for future improvement approaches.
德国尸体器官捐赠数量持续低迷，这一情况多次引发政治讨论，最近还促成了《移植法》的修订，强化了移植官员的作用，并引入了一份登记册来记录捐赠意愿。这些决策的背景是，人们认为医院中有相当一部分潜在器官捐赠者被忽视且未被上报。然而，由于缺乏关于何时必须向德国器官捐赠基金会（“Deutsche Stiftung Organspende”）上报潜在器官捐赠者的指导方针，现有数据的有效性有限。
因此，北莱茵 - 威斯特法伦州（NRW）大学医院的移植官员们商定采用此处提出的HEW评分（脑功能丧失 - 适用性 - 意愿）作为上报潜在器官捐赠者的统一标准。
为三个纳入属性分别赋予1至3分，得出的分数范围为111至333，若超过阈值213，则建议向德国器官捐赠基金会上报。为实施该评分，回顾性收集了2022年波恩、埃森和杜塞尔多夫大学医院通过移植检查确定的病例的HEW评分，并在本文中呈现。
总体而言，根据HEW评分应上报的病例数比所有三个地点实际上报的病例数低13.5%（126例对109例）。在所有三个中心，拒绝率都很高，为54.5% - 64.9%。
HEW评分是一种用于详细记录和标准化上报潜在器官捐赠者的工具，可实现统一的上报行为，作为未来改进措施的数据基础。
