Nicholson M L, Dunlop P, Doughman T M, Wheatley T J, Butterworth P C, Varty K, Lennard N, Veitch P S, Bell P R
University Department of Surgery, Leicester General Hospital, UK.
Transpl Int. 1996;9(6):603-6. doi: 10.1007/BF00335564.
The work-load generated by a non-heart-beating donor (NHBD) kidney transplant programme over a 3-year period is reported. A total of 73 referrals were made, 64 from the Accident department and 9 from the wards. Organ procurement was performed in 24 cases (33%) and resulted in the retrieval of 44 kidneys. Reasons for failure to achieve organ procurement were; refused consent (n = 13; 18%), relatives unavailable to ask for consent (n = 9; 12%), technical problems with catheter insertion or perfusion (n = 10; 14%), transplant staff unavailable (n = 1; 1%), long asystolic period (n = 8; 11%) and donor unsuitable for other reasons (n = 8; 11%). Of the 44 kidneys retrieved, 30 were transplanted locally, 8 were transplanted at other United Kingdom centres and 6 were discarded. Locally transplanted NHBD kidneys represented 21% of the total transplant programme during the time period under study. We conclude that NHBD kidneys are a good source of additional organs for transplantation, but only one-third of referrals result in a successful procurement procedure. Moreover, the setting up of a successful programme is labour-intensive and requires a highly committed staff.
本文报告了一个非心脏跳动供体(NHBD)肾脏移植项目在3年期间产生的工作量。共收到73例转诊,其中64例来自急诊科,9例来自病房。24例(33%)进行了器官获取,共获取了44个肾脏。未能成功进行器官获取的原因包括:拒绝同意(n = 13;18%)、亲属无法联系以征求同意(n = 9;12%)、导管插入或灌注技术问题(n = 10;14%)、移植工作人员无法到位(n = 1;1%)、心脏停搏期过长(n = 8;11%)以及供体因其他原因不适合(n = 8;11%)。在获取的44个肾脏中,30个在当地进行了移植,8个在英国其他中心进行了移植,6个被丢弃。在研究期间,当地移植的NHBD肾脏占总移植项目的21%。我们得出结论,NHBD肾脏是移植额外器官的良好来源,但只有三分之一的转诊能成功进行获取程序。此外,建立一个成功的项目劳动强度大,需要高度敬业的工作人员。