供者管理模式对器官捐献结局的影响

Effect of donor management scheme on organ donation outcome

目的探讨器官捐献工作组(ODWG)管理模式对器官捐献结局的影响。方法回顾性分析2018年1月到2020年6月中山大学附属第三医院器官获取组织接收的182例供者临床资料。其中男150例,女32例;平均年龄(42±15)岁。以2019年3月作为时间节点将供者分为ODWG组(108例)和对照组(74例)。患者均签署知情同意书,符合医学伦理学规定。比较两组供者捐献类型、捐献器官质量控制指标等。两组率的比较采用χ^(2)检验。结果本组捐献成功率为70%(128/182)。脑死亡器官捐献(DBD)供者91例,心脏死亡器官捐献(DCD)80例。ODWG组DBD占67%(68/102),明显高于对照组的33%(23/69)(χ^(2)=18.37,P<0.05)。ODWG组器官紧急获取率为1%(1/102),明显低于对照组的10%(7/69)(χ^(2)=5.71,P<0.05)。ODWG组获取器官数295个,丢弃器官数22个,器官利用率93%(273/295),器官产出率268%(273/102),对照组相应为198个、26个、87%(172/198)、249%(172/69),ODWG组的器官利用率和器官产出率优于对照组。结论ODWG管理模式可明显提高器官捐献率,扩大器官池,是保证捐献-移植安全有效的方案。

Objective To evaluate the effect of Organ Donation Work Group(ODWG)management scheme on the outcome of organ donation.Methods Clinical data of 182 donors admitted to Organ Procurement Organization(OPO)in the Third Affiliated Hospital of Sun Yat-sen University from January 2018 to June 2020 were retrospectively analyzed.Among them,150 donors were male and 32 female,aged(42±15)years on average.Regarding March 2019 as the time point,all donors were divided into the ODWG(n=108)and control groups(n=74).The informed consents of all patients were obtained and the local ethical committee approval was received.The donor donation types and parameters of quality control of donated organs were statistically compared between two groups.The rate comparison was performed by Chi-square test.Results The success rate of organ donation was 70%(128/182).Among them,91 cases were donation after brain death(DBD)and 80 cases were donation after cardiac death(DCD).In the ODWG group,the proportion of DBD cases was 67%(68/102),significantly higher than 33%(23/69)in the control group(χ^(2)=18.37,P<0.05).In the ODWG group,the emergency organ procurement rate was 1%(1/102),significantly lower than 10%(7/69)in the control group(χ^(2)=5.71,P<0.05).In the ODWG group,the number of procured organs was 295,the number of discarded organs was 22,the utilization rate of organs was 93%(273/295),the output rate of organs was 268%(273/102).They were correspondingly 198,26,87%(172/198)and 249%(172/69)in the control group.The organ utilization rate and output rate in the ODWG group were higher than those in the control group.Conclusions ODWG management scheme can significantly improve the organ donation rate and expand the organ pool,which is a protocol to guarantee the efficacy and safety of organ donation-transplantation.