单中心器官捐献成功175例分析

Clinical analysis of 175 successful cases of donation after citizens＇ death in single center

目的对器官捐献成功的案例进行分析，总结临床特点和处理经验。方法收集自2007年至2014年175例器官捐献成功案例，从供者年龄、死亡原因、机械灌注类型及基本处理策略等方面进行分析。结果175例供者中男性129例（73．7％），年龄〈50岁的供者有160例（91．4％）。死因构成比前3位的分别是颅脑损伤（95例）、脑血管意外（43例）及脑肿瘤（15例），构成比分别为54．3％（95／175）、24．6％（43／175）及8．6％（15／175），这3种死因的总构成比为87．4％（153／175）。各组死因中的年龄构成比以〈50岁的年轻患者居多，构成比合计超过80％。职业类别中无职业（成人）、体力劳动及学生类别的构成比较高，分别为23．4％（41／175）、51．4％（90／175）及20．6％（36／175）。受教育程度类别中，小学与中学的构成比分别为30．3％（53／175）与54．9％（96／175）。儿童供者共有48例，死因以颅脑损伤较多（25例），构成比为52．1％（25／48）。器官捐献类别中，国内标准脑死亡器官捐献类型的构成比高达95．4％（167／175）。二级、二级以下医院的构成比合计为54．3％（95／175）。在供者使用的机械灌注类型中，42例采用体外膜肺氧合（ECMO），56例采用肾脏灌注运转箱（Lifeport），构成比分别为24％（42／175）与32％（56／175）。肝与肾的器官获取率均为100％，利用率分别为64．6％（113／175）与95．4％（334／350）。结论DBD供者器官维护已经形成临床处理体系，为建立多渠道、高质量的供者来源与提高器官利用率提供了前期临床研究基础。

Objective To analyze the clinical characteristics of 175 successful cases of donation after citizens＂ death inour center and summarize the clinical experience. Methods From 2007 to 2014, the constituent of age, cause of death and machine perfusion or the management principles were analyzed and determined in the 175 successful cases of after citizens＂ death. Results The constituent ratio of clinical indexes was as follows： male 129/175 （73. 7%）, age 〈50 years 91.4% （160/175）. The top 3 causes of death were craniocerebral injury, cerebralvascular accident and cerebral tumor, and the total constituent was 87. 4% （153/175）. In any one group of cause of death, the total constituents of patients （age 〈50 years） were more than 80%. In the group of occupation, the top 3 constituent ratio was physical activity, 51.4% （90/175）, unemployed people, 23.4% （41/175） and student 20. 6% （36/175）. In the education level, the constituent ratio of primer and secondary school was 54.9% （96/175） and 30.3%/4 （53/175） respectively. In 48 cases of children donors, top 1 etiology was caniocerebral injury, 25 cases, 52. 1% （25/48）. In the death model of donation, high constituent ratio of DBD was 95. 4% （167/175）. In the machine perfusion, 42 cases were given ECMO, 24% （42/175）, LifePort, 56 cases, 32% （56/175）. The output ratio of liver and kidney was 100%, and its utilization ratio was 64. 6%（113/175） and 95.4% （334/350） respectively. Conclusion The organ protection system of DBD is established. It can provide the research basis for improving the sources, quality and utilization of donor organs.