Direct Measurement of DCD Donor Potential.

IF 5.3 2区医学 Q1 IMMUNOLOGY

Transplantation Pub Date : 2024-09-05 DOI:10.1097/TP.0000000000005188

Tom Mone, Tom Rosenthal, Tom Seto

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引用次数: 0

Abstract

Background: Existing methods of comparing organ procurement organization (OPO) performance use administrative data to indirectly measure donation after circulatory death (DCD). The purpose of this study was to categorize and quantify reasons that potential DCD donors do not progress to donation to facilitate the direct measurement of OPO donor potential.

Methods: Records of all 18 685 potential organ donors referred to the organ procurement agency OneLegacy in 2021 and 2022 were reviewed, and reasons that cases did not proceed to donation were categorized and quantified. All hospital deaths were reviewed through tissue referrals and chart audits to assess whether potential organ donors were not referred.

Results: There were 8349 potential DCD donors. Of these, 5640 cases were ruled out for clinical reasons, and 1458 cases were ruled out for factors unique to DCD, such as ventilation, which was never withdrawn. Of the 1251 ruled in for the family approach to donation consent, there were ultimately 191 donors with organs transplanted.

Conclusions: OPO donor potential calculated from referral and hospital death record reviews is substantially lower than donor potential determined by administrative data, validating the need for direct measurement for regulatory purposes and performance improvement. For a usable direct measure of donor potential, DCD donor criteria must be codified, electronic donor records optimized, and audit processes developed.

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直接测量 DCD 捐献者潜能。

背景：比较器官获取组织（OPO）绩效的现有方法使用行政数据来间接衡量循环死亡（DCD）后的捐献。本研究的目的是对潜在的循环死亡后捐献者没有进行捐献的原因进行分类和量化，以便于直接衡量OPO捐献者的潜力：方法：对2021年和2022年转介至器官获取机构OneLegacy的所有18 685名潜在器官捐献者的记录进行了审查，并对未进行捐献的原因进行了分类和量化。通过组织转介和病历审计对所有医院死亡病例进行审查，以评估潜在器官捐献者是否未被转介：结果：共有 8349 例潜在的 DCD 捐献者。结果：共有 8349 例潜在的 DCD 捐献者，其中 5640 例因临床原因而被排除，1458 例因 DCD 独有的因素而被排除，例如从未撤除的通气。在因家属同意捐献而被排除的 1251 例捐献者中，最终有 191 例捐献者的器官被移植：结论：通过转诊和医院死亡记录审查计算出的 OPO 潜在捐献者人数大大低于通过行政数据确定的潜在捐献者人数，这证明有必要为监管目的和提高绩效进行直接测量。要想对捐献者潜能进行可用的直接测量，必须编纂 DCD 捐献者标准，优化电子捐献者记录，并制定审计流程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation 医学-免疫学

CiteScore

8.50

自引率

11.30%

发文量

1906

审稿时长

1 months

期刊介绍： The official journal of The Transplantation Society, and the International Liver Transplantation Society, Transplantation is published monthly and is the most cited and influential journal in the field, with more than 25,000 citations per year. Transplantation has been the trusted source for extensive and timely coverage of the most important advances in transplantation for over 50 years. The Editors and Editorial Board are an international group of research and clinical leaders that includes many pioneers of the field, representing a diverse range of areas of expertise. This capable editorial team provides thoughtful and thorough peer review, and delivers rapid, careful and insightful editorial evaluation of all manuscripts submitted to the journal. Transplantation is committed to rapid review and publication. The journal remains competitive with a time to first decision of fewer than 21 days. Transplantation was the first in the field to offer CME credit to its peer reviewers for reviews completed. The journal publishes original research articles in original clinical science and original basic science. Short reports bring attention to research at the forefront of the field. Other areas covered include cell therapy and islet transplantation, immunobiology and genomics, and xenotransplantation.