已故器官捐赠者中药物过量和心血管死亡:对捐赠者利用和数据报告的影响
Michie A Adjei1, Steven A Wisel2, Irene K Kim2
1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Annals of transplantation
|July 4, 2023
概括
扩展的死亡原因定义揭示了器官供体利用的显著差异. 药物中毒捐赠者越来越多地被用于脑死亡捐赠,而创伤捐赠者仍然是循环死亡捐赠的关键.
科学领域:
- 移植研究 移植研究
- 器官供体管理器官供体管理
- 公共卫生 公共卫生
背景情况:
- 目前的死亡原因 (COD) 定义可能无法完全捕捉捐赠者的特征.
- 了解捐赠者的人口统计和COD对于优化器官利用至关重要.
研究的目的:
- 评估扩展的死亡原因 (COD) 定义.
- 评估这些定义对固体器官供体利用的影响.
主要方法:
- 对OPTN标准移植和研究文件 (2005-2019) 的分析.
- 对捐赠者和特定器官的利用率的评估.
- 基于扩大COD (创伤,心血管,脑血管事故/中风,药物中毒,无氧-NOS,其他) 的供体利用的描述性和多变量后勤回归分析.
主要成果:
- 脑血管事故/中风是最常见的COD (33.7%),其次是创伤 (32.7%).
- 心血管捐赠者具有最低的未调整利用率 (90.1%).
- 与创伤相比,药物中毒的捐赠者在脑死亡的捐赠者中显示出更高的利用可能性 (OR 1.217).
- 与创伤相比,心血管捐赠者在脑死亡 (OR 0.717) 和循环死亡捐赠者 (OR 0.607) 中的利用率较低.
结论:
- 扩大COD定义是必要的,以反映捐赠人群的差异.
- 药物中毒捐赠者代表着一个不断增长的队列,并且在脑死亡捐赠中得到了高度利用.
- 在循环死亡情景之后,创伤捐赠者仍然是捐赠中使用最多的.
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