新型冠状病毒肺炎疫情下开展公民逝世后器官捐献的经验探讨

Discussion on the experience of organ donation after citizen's death under COVID-19 epidemic

目的总结新型冠状病毒肺炎(新冠肺炎)疫情下开展公民逝世后器官捐献的经验。方法回顾性分析疫情期间11例公民逝世后器官捐献潜在供者案例,总结工作流程和感染防控要点。结果11例潜在供者中,6例未成功实施器官捐献。成功实施器官捐献的5例供者脑病发作前无呼吸道症状,脑病发作时入院行肺部CT检查提示1例为吸入性肺炎,余4例检查结果为阴性。住院期间5例供者全部出现发热症状,再次行胸部CT检查均提示肺部炎症,经支气管肺泡灌洗液或血液标本检测新型冠状病毒核酸全部为阴性。所有密切接触器官捐献者的工作人员和受者无确诊或疑似病例出现。结论新冠肺炎疫情下针对性制定工作流程和防控措施,结合感染风险分级选择实施,可有效降低感染风险、安全有序地开展公民逝世后器官捐献工作。

Objective To summarize the experience of organ donation after citizen's death during the novel coronavirus pneumonia(COVID-19)epidemic.Methods Eleven cases of potential donors of organ donation after citizen's death during the COVID-19 epidemic were retrospectively analyzed,and the workflow and key points of infection prevention and control were summarized.Results Among 11 cases of potential donors,6 cases failed to implement organ donation.Five donors who were successfully performed organ donation had no respiratory symptoms before the onset of encephalopathy.CT scan of the lungs upon the onset of encephalopathy showed that one case was diagnosed with aspiration pneumonia,and the remaining four cases obtained negative results.During hospitalization,all of the 5 donors showed fever symptom and repeated chest CT scan detected lung inflammation.Bronchoalveolar lavage fluid or blood samples tested for novel coronavirus nucleic acids were all negative.No confirmed or suspected cases appeared among all staff and recipients who were in close contact with organ donors.Conclusions Targeted formulation of the workflow and prevention and control measures,in combination with selection and implementation of infection risk classification can effectively reduce the risk of COVID-19 infection and carry out organ donation after citizen's death in a safe and organized manner.