联合OPO对器官捐献和获取质量控制指标的影响——基于福建省单中心数据

Effect of united OPO on organ donation and procurement quality control indexes:a study based on single-center data in Fujian province

目的探讨联合器官获取组织(OPO)对器官捐献工作及器官捐献质量控制指标的影响。方法回顾性分析联合OPO牵头医疗机构联合前、后器官捐献成功的36例、33例案例在器官捐献工作量和工作效率情况以及器官捐献质量控制和管理指标的差异。结果联合OPO成立后器官捐献工作量和工作效率均得到进一步提升,年捐献例数、年器官获取数、日均获取器官数、每百万人口捐献率(PMP)、协调员工作效率指数等指标进一步提高。器官捐献转化率由联合前的26.5%提升至联合后的29.0%,平均器官产出率在联合OPO成立前后相差不大,维持在3.3以上的高水平,与联合OPO成立前比较,联合OPO成立后获取器官利用率、边缘供器官比例、器官保存液病原菌培养阳性率、移植物原发性无功能(PNF)发生率、移植物功能延迟恢复(DGF)发生率等,差异均无统计学意义(均为P>0.05);联合OPO成立前、后的捐献器官获取后活组织检查率分别为27.7%和58.3%,而器官外流率分别为83.1%和47.8%,差异均有统计学意义(均为P<0.05)。结论联合OPO建设有助于推动器官捐献和获取工作高效发展,降低器官捐献和获取成本,提高器官捐献和获取工作成效和质量控制与管理水平。

Objective To evaluate the effect of united Organ Procurement Organization(OPO)on organ donation and procurement quality control indexes.Methods The differences in organ donation workload,work efficiency,organ donation quality control and management indexes in a united OPO-led hospital were retrospectively analyzed before(n=36)and after(n=33)the establishment of united OPO.Results After the establishment of united OPO,the organ donation workload and efficiency were enhanced.The annual donation cases,annual organ procurement cases,average organ procurement cases per day,organ donation rate of per million population(PMP),coordinator work efficiency index and other indexes were further improved.Before the establishment of united OPO,the donation conversion rate was 26.5%,and increased up to 29.0%after the establishment of united OPO.The average organ yield rate remained higher than 3.3 before and after the establishment of united OPO.No significant differences were noted in the utilization rate of procured organs,proportion of marginal donor organs,positive rate for pathogen culture in organ preservation solution,the incidence of primary nonfunction(PNF)and delayed graft function(DGF)before and after the establishment of united OPO(all P>0.05).The biopsy rates of donated organs were 27.7%and 58.3%,and the organ outflow rates were 83.1%and 47.8%before and after the establishment of united OPO,and the differences were statistically significant(both P<0.05).Conclusions The establishment of united OPO contributes to promoting efficient development of organ donation and procurement,lowering the cost of organ donation and procurement,and improving the effectiveness,quality control and management levels of organ donation and procurement.