基于移植协调员角度的心脏死亡器官捐献工作经验

Experience of cardiac death organ donation based on the transplant coordinator

目的总结基于移植协调员角度的心脏死亡器官捐献（DCD）工作经验。方法收集2010年3—10月间潜在DCD供者的临床资料，通过自定义4个概念：潜在DCD供者、有效DCD供者、DCD成功率及DCD回绝率，对DCD工作进行量化分析。结果发现并确认了16例潜在DCD供者，并成功实施DCD5例，DCD成功率为31．3％（5／16）。11例未成功捐献的潜在DCD供者中，其原因为家属拒绝捐献3例（占27．3％），家属捐献意见不统一3例（占27．3％），家属同意捐献但由于各种纠纷或与各部门协调原因耽误器官获取时间造成器官质量不符合捐献标准4例（占36．4％），以及器官评估不合格1例（9．1％）。DCD回绝率为37．5％（6／16）。结论潜在DCD供者的人数还有待提高；移植协调员在人体器官捐献工作中具有重要作用，沟通技巧、专业知识仍需要进一步培养；人体器官捐献工作不能仅依靠医疗卫生部门、省红十字会，需要行政、交通、司法等各部门的协同参与。

Objective To research the experience of cardiac death organ donation based on the transplant coordinator. Methods Survey was made in The Third Xiangya Hospital of Central South University, and potential donors＇ data were collected from March to October, 2010. Through defining four concepts： potential DCD donors, effective DCD donor, success ratio of DCD donor, rejection ratio of DCD donors, the DCD work was quantitatively analyzed. Results There were 16 potential DCD donors and 5 effective DCD donors, and the success ratio of DCD donor was 31.3 % （5/16）. In the 11 failure cases, there were 3 cases （27. 3 %） whose family refused to donate, 3 cases （27. 3 %） whose family had no consentaneous opinions on denotation, 4 cases （36. 4 %） whose organ quality did not meet the criteria because of delaying time when dealing with various kinds of disputes or coordinating with various departments, and one case （9. 1 %） whose donated organ was unqualified. Rejection ratio of DCD donors was 37. 5 % （6/16）. Conclusion We need to do efforts to further improve the potential DCD donors＇ discovery. Transplantation coordinator plays an important role in human organ donation work, whose communication skills and professional knowledge still need to be further trained. It is not enough to just rely on the medical department and Red Cross, human organ donation work needs the collaborative participation among the administrative department, the traffic department and the department of justice.