K. A. Chotkan, I. Alwayn, A. Hemke, A. Baranski, W. Nijboer, R. A. Pol, A. Braat
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引用次数: 0
摘要
本研究分析了 10 年来的采购质量监测数据,以确定与采购相关损伤有关的潜在风险因素及其与长期移植物存活率的关系。研究回顾性地纳入了 2012 年至 2022 年期间荷兰所有已故肾脏、肝脏和胰腺捐献者及其相应的受者。研究人员分析了采购相关损伤的发生率和潜在风险因素。在所有采集的腹部器官中,23%出现了与采集相关的损伤,丢弃率为4.0%。在肾脏和肝脏中,23%的移植物存在采购相关损伤,分别有 2.5%和 4%的采购相关损伤器官被丢弃。在胰腺采集中,这一比例为 27%,废弃率为 24%。男性捐献者性别和捐献者体重指数(BMI)大于 25 是造成所有三个腹部器官采购相关损伤的重要风险因素,而血管异常仅对肾脏和肝脏有重要影响。在多变量 Cox 回归分析中,采购相关损伤不是移植失败的重要预测因素(肾脏;HR 0.99,95% CI 0.75-1.33,p = 0.99;肝脏;HR 0.92,95% CI 0.66-1.28,p = 0.61;胰腺:HR 1.16; 95% CI 0.16-8.68, p = 0.88)。本研究的结果表明,移植外科医生在确定采购相关损伤的可接受性和可修复性时表现出了良好的决策技能。
Ten Years of Quality Monitoring of Abdominal Organ Procurement in the Netherlands and Its Impact on Transplant Outcome
In this study, 10 years of procurement quality monitoring data were analyzed to identify potential risk factors associated with procurement-related injury and their association with long-term graft survival. All deceased kidney, liver, and pancreas donors from 2012 to 2022 and their corresponding recipients in the Netherlands were retrospectively included. The incidence of procurement-related injuries and potential risk factors were analyzed. Of all abdominal organs procured, 23% exhibited procurement-related injuries, with a discard rate of 4.0%. In kidneys and livers, 23% of the grafts had procurement-related injury, with 2.5% and 4% of organs with procurement-related injury being discarded, respectively. In pancreas procurement, this was 27%, with a discard rate of 24%. Male donor gender and donor BMI >25 were significant risk factors for procurement-related injury in all three abdominal organs, whereas aberrant vascularization was significant only for the kidney and liver. In the multivariable Cox regression analyses, procurement-related injury was not a significant predictor for graft failure (kidney; HR 0.99, 95% CI 0.75–1.33, p = 0.99, liver; HR 0.92, 95% CI 0.66–1.28, p = 0.61, pancreas: HR 1.16; 95% CI 0.16–8.68, p = 0.88). The findings of this study suggest that transplant surgeons exhibited good decision-making skills in determining the acceptability and repairability of procurement-related injuries.