供体库中隐藏的宝藏:分析未用作移植物的捐献心脏

Emre Aygün, Ümit Kervan, Mehmet Karahan, A. Teki̇n, Muhammed Ertugrul Egi̇n, Sinan Sabit Kocabeyoğlu, Doğan Emre Sert, Mustafa Paç
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摘要

目的:旨在调查脑死亡患者器官捐献的过程,研究从器官捐献到移植的步骤,揭示未使用或拒绝捐献者的原因,并提出解决方案。研究方法在 2015 年 1 月至 2016 年 12 月期间,我们查阅了卫生部捐献者登记数据、国家协调中心档案部门的档案,对家属许可批准的所有遗体捐献者进行了调查。结果:共调查了 985 名捐献者,其中 65% 为男性,平均年龄为 47.5 岁(0-96 岁),65% 的捐献者因神经系统原因导致脑死亡。平均脑死亡报告持续时间为 5.4 ± 9.3 (1-169) 天。共发现 169 例(17.1%)供体感染。重症监护室平均住院时间为 8.55 ± 4.42 (2-38) 天。只有 16.2%(159 例)的供体使用了心脏移植物。495名(50.2%)捐献者因医疗原因被拒绝,64名(6.5%)捐献者因中心拒绝而不符合心脏移植条件。20%的潜在捐献者没有获得家属的同意进行心脏捐献。在未获得家属批准的捐献者中,70%的捐献者年龄在 65 岁以下,其中 67% 的捐献者没有任何医疗问题,因此不需要使用心脏作为移植物。在未获得心脏移植许可的捐献者中,肝脏移植率为 71%,肾脏移植率为 70%。结论我们需要器官移植团队,他们将负责并领导从脑死亡诊断到捐献者护理的整个过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Donör Havuzunun Gizli Hazinesi: Greft Olarak Kullanılmayan Donör Kalplerinin Analizi
Purpose: The aim was to investigate the course of organ donation in patients with brain death, examine the steps from organ donation to transplant, reveal the reasons of donors that are not used or are refused and to propose a solution. Methods: Between January 2015 to December 2016, we reviewed data of donor registry in Ministry of Health, Department of the National of Coordination Center archives of all cadaveric donors whose family permit approved were investigated. Results: 985 donors were examined; 65% was male, mean age was 47.5 (0-96) and 65% of the donors had brain death due to neurological reasons. Mean brain death report duration was 5.4 ± 9.3 (1-169) days. A total of 169 (17.1%) infections in donors were detected. Mean intensive care unit stay was 8.55 ± 4.42 (2-38) days. Only 16.2% (159) heart grafts were used in donors. 495 (50.2%) donors were rejected for medical reasons, 64 donors (6.5%) were not eligible for heart grafts due to rejection by centers. Family approval for the heart donation was not obtained in 20% of the potential donors. 70% of donors without family approval was under 65 year-old and 67% of them did not have any medical problems for avoiding heart usage as a graft. In donors without heart approval as a graft, rate of liver use as a graft was 71% and rate for kidney was 70%. Conclusion: We need organ transplant teams who will conduct and lead the process from the diagnosis of brain death to the care of donors.
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