循环确定死亡捐赠者利用率后的捐赠趋势:休斯顿的经验教训

Q4 Medicine
Andrew B. Barboza , Naila H Dhanani , Kristine Browning , R. Patrick Wood , David R Hall
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引用次数: 0

摘要

现代的进步使得器官移植成为器官衰竭患者越来越可行的选择。由于等待移植的时间增加,等待移植的患者增加,导致了显著的发病率和死亡率。使用循环确定死亡(DCD)器官捐献者捐献是解决器官移植需求增加的最成功途径。这篇综述简要介绍了以总部位于休斯顿的生命捐赠器官采购组织(OPO)为代表的美国DCD器官捐赠的历史。方法获取来自移植受者科学登记处(SRTR)的器官捐赠数据和OPO的特定数据,包括所有可用于LifeGift的DCD捐赠者。在器官共享联合网络政策的背景下,分析了DCD捐赠的趋势。结果到2021年底,美国20%的捐赠器官来自DCD捐赠者,自20世纪90年代中期以来呈稳步增长趋势。UNOS用来监测器官捐献率和OPO表现的指标并不能清楚地捕捉到潜在的DCD捐献者。个别opo在利用DCD捐赠者方面取得了不同程度的成功,像LifeGift这样的opo侧重于提高DCD的利用率。结论在美国,dcd的使用仍然是增加死者供体器官库最成功的途径。增加移植中心对DCD器官的利用和opo集中努力促进DCD捐赠可以改善全国器官短缺问题。提高UNOS指标的清晰度可以进一步促进OPO绩效评估,并促进美国进一步的DCD捐赠。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends in donation after circulatory determination of death donor utilization: Lessons from Houston

Background

Modern advancements have made organ transplantation an increasingly viable option for patients with organ failure. The resulting increases in patients awaiting transplant has resulted in significant morbidity and mortality due to increasing waiting time for transplant. The use of Donation after Circulatory Determination of Death (DCD) organ donors has been the most successful avenue to address the increased need for organ allografts. This review provides a brief history of DCD organ donation in the United States as represented by the experience of the Houston-based LifeGift Organ Procurement Organization (OPO).

Methods

Organ donation data from the Scientific Registry of Transplant Recipients (SRTR) and OPO specific data to include all available DCD donors for LifeGift were obtained for analysis. Trends in DCD donation were analyzed in the context of United Network for Organ Sharing policy.

Results

By the end of 2021 20% of organs donated in the United States were from DCD donors, in a steadily increasing trend since the mid-1990′s. Metrics utilized by UNOS to monitor organ donation rates and OPO performance do not clearly capture potential DCD donors. Individual OPOs have varying success in utilization of DCD donors, with OPOs like LifeGift focusing on increased DCD utilization.

Conclusion

DCD utilization remains the most successful avenue for increasing the deceased donor organ pool in the United States. Increased utilization of DCD organs by transplant centers and focused efforts by OPOs to promote DCD donation can improve the organ shortage nationally. Improved clarity in UNOS metrics can further facilitate OPO performance evaluation and promote further DCD donation in the United States.

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来源期刊
Transplantation Reports
Transplantation Reports Medicine-Transplantation
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
101 days
期刊介绍: To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
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