SARS-CoV-2 大流行对一家教学医院眼组织捐赠的影响

Adriana Carla de Miranda Magalhaes, Edna Andrea Pereira de Carvalho, Joel Edmur Boteon, Luciana Cristina dos Santos Silva, Tatiane Batista Chaves de Faria, Rene Coulaud Santos da Costa Cruz, Silvia Zenobio Nascimento
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The number of donations made, the number of deaths potentially eligible for donation, and the causes of non-donation were compared during the three periods of 2020: period 1, pre-pandemic ( January 1 to March 18, 2020), period 2, with suspension of donations in cardiorespiratory arrest (March 19 to September 19, 2020), and period 3, of collections with epidemiological screening for SARS-CoV-2 and reduction of the age range of donors less than 65 years old (September 20 to December 31 2020). Results: There were 710 circulatory deaths in 2020. The hospital eligibility rate was 5.7% among 140 deaths in the pre-pandemic period 1, 11.9% among 395 patients during the suspension of uptake in pandemic period 2, and 3.4% among 175 patients during age group restrictions and coronavirus disease 2019 (COVID-19) screening (p:0.004). 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摘要

目的分析严重急性呼吸系统综合征冠状病毒(SARS-CoV-2)大流行对眼部组织捐献的影响,评估由于暂停采集和资格标准的改变而导致潜在捐献者失去的机会,以及医院的捐献者合格率和不捐献的原因。方法分析了巴西一所大学医院 2020 年心肺骤停死亡患者的数据。比较了 2020 年三个时期的捐献数量、可能符合捐献条件的死亡人数以及未捐献的原因:第一时期,大流行前(2020 年 1 月 1 日至 3 月 18 日);第二时期,暂停心肺骤停患者的捐献(2020 年 3 月 19 日至 9 月 19 日);第三时期,进行 SARS-CoV-2 流行病学筛查并缩小 65 岁以下捐献者的年龄范围(2020 年 9 月 20 日至 12 月 31 日)。结果:2020 年有 710 例循环系统死亡病例。在大流行前 1 期的 140 例死亡病例中,住院合格率为 5.7%;在大流行 2 期暂停接收期间的 395 例患者中,住院合格率为 11.9%;在年龄组限制和 2019 年冠状病毒病(COVID-19)筛查期间的 175 例患者中,住院合格率为 3.4%(P:0.004)。第 2 阶段死亡的 47 名患者因暂停采集而失去了捐献机会,第 3 阶段的 175 名患者中有 13 人(7.6%)因年龄组减少而不符合捐献条件。由于大流行的限制,在 75 名符合条件且无临床禁忌症的患者中,81% 的患者获得了有限的组织捐献机会。只有一名患者因 SARS-CoV-2 的临床流行病学筛查而被认为不符合捐献条件。在这三个时期中,分别有 50.7%、48.1% 和 47.4% 的死亡病例(P:0.615)的主要原因是严重感染。结论由于出于安全考虑而实施的限制措施,SARS-CoV-2 大流行严重影响了用于移植的眼组织的获取,导致 81% 的家庭失去了捐献机会。年龄限制大大降低了潜在捐赠者的合格率。严重感染是导致不捐献眼组织的主要原因,但在本研究中,在大流行期间,这种情况并没有明显增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of SARS-CoV-2 Pandemic on Ocular Tissue Donation in a Teaching Hospital
Objectives: To analyze the impact of the severe acute respiratory syndrome coronavirus (SARS-CoV-2) pandemic on ocular tissue donations, assessing lost opportunities for potential donors due to the suspension of collections and changes in eligibility criteria, as well as hospital eligibility rates of donors and causes of non-donation. Methods: Data from patients who died in cardiopulmonary arrest in a Brazilian university hospital in 2020 were analyzed. The number of donations made, the number of deaths potentially eligible for donation, and the causes of non-donation were compared during the three periods of 2020: period 1, pre-pandemic ( January 1 to March 18, 2020), period 2, with suspension of donations in cardiorespiratory arrest (March 19 to September 19, 2020), and period 3, of collections with epidemiological screening for SARS-CoV-2 and reduction of the age range of donors less than 65 years old (September 20 to December 31 2020). Results: There were 710 circulatory deaths in 2020. The hospital eligibility rate was 5.7% among 140 deaths in the pre-pandemic period 1, 11.9% among 395 patients during the suspension of uptake in pandemic period 2, and 3.4% among 175 patients during age group restrictions and coronavirus disease 2019 (COVID-19) screening (p:0.004). Forty-seven patients who died in period 2 represented a loss of donation opportunities due to the suspension of collections, and 13 (7.6%) of the 175 patients in period 3 were ineligible due to the reduction in age group. Due to pandemic restrictions, eighty-one percent of the 75 eligible patients without clinical contraindications had limited tissue donation offers. Only one patient was considered ineligible for donation due to clinical-epidemiological screening for SARS-CoV-2. Serious infections were the leading cause of non-donation in 50.7, 48.1, and 47.4% of deaths in the three periods (p:0.615). Conclusion: The SARS-CoV-2 pandemic significantly affected the procurement of ocular tissues for transplants due to the restrictive measures implemented for safety reasons, leading to the loss of donation opportunities for 81% of families. Age restrictions significantly reduced potential donor eligibility rates. Serious infections were the leading cause of non-donation of ocular tissue, but it did not increase significantly in this study during the pandemic, in the period studied.
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