Single-center data analysis of organ donation and utilization after citizen's death
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摘要:
目的 了解无锡地区公民逝世后器官捐献及利用现状,为促进局部地区器官捐献工作的进一步开展提供思路和依据。 方法 回顾性分析151例器官捐献者的临床资料,其中器官捐献成功者37例,潜在捐献者114例。分析潜在捐献者捐献失败的原因;收集器官捐献成功者的一般资料;分析器官捐献成功者的器官捐献情况和器官利用情况。 结果 151例器官捐献者中,器官捐献成功者37例,捐献转化率为24.5%。器官捐献失败者114例,捐献失败的原因分别为家属不同意、未达到捐献状态标准、无充足时间评估和工伤纠纷未解决。器官捐献类别包括34例脑-心双死亡器官捐献(DBCD),3例脑死亡器官捐献(DBD),无心脏死亡器官捐献(DCD)。捐献者死亡原因包括19例颅脑外伤、14例脑卒中和4例其他。37例器官捐献成功者中,以流动人口为主。捐献者共捐献大器官和组织154个,其中大器官124个。人均大器官和组织捐献个数(4.2± 1.6)个,人均大器官捐献个数(3.4± 1.1)个。154个捐献器官中,利用率为96.7%(149/154),器官分配前4位城市为南京、无锡、苏州、常州。 结论 无锡地区公民逝世后器官捐献成功率及捐献转化率偏低,应建立局部地区器官捐献工作网络、加大器官捐献宣传力度以及开展协调员技能培训。 -
关键词:
- 公民逝世后器官捐献 /
- 器官获取组织 /
- 器官移植 /
- 终末期器官衰竭 /
- 潜在捐献者 /
- 脑-心双死亡器官捐献(DBCD) /
- 脑死亡器官捐献(DBD) /
- 心脏死亡器官捐献(DCD)
Abstract:Objective To get a knowledge of the current status of organ donation and utilization after citizen's death in Wuxi District, and thereby provide ideas and basis for further development of organ donation work in local areas. Methods Clinical data from 151 organ donors, included 37 successful donors and 114 potential donors, were retrospectively analyzed. The reasons for donation failure of potential donors were analyzed. The general information for successful donors was collected. And the information on organ donation and organ utilization in successful donors were analyzed. Results Among the 151 organ donors, 37 were successful donors, with the conversion rate reaching 24.5%. For the 114 donors with failed organ donation, the reasons for failure included family disagreement, failure to meet donation status criteria, insufficient evaluation time, and unresolved work injury disputes. The categories for organ donation included 34 cases of donation after brain death followed by cardiac death (DBCD), 3 cases of donation after brain death (DBD), and no case of donation after cardiac death (DCD). The reasons for death of donors includes 19 cases of craniocerebral trauma, 14 cases of stroke and 4 cases of others. Among the 37 cases of successful donors, the majority were floating population. A total of 154 major organs and tissues were donated, of which 124 were major organs. The number of major organs and tissues donated per citizen was (4.2± 1.6) and the number of major organs donated per citizen was (3.4± 1.1). The utilization rate of the 154 donated organs reached 96.7% (149/154), with Nanjing, Wuxi, Suzhou and Changzhou ranking the top 4 of organ distribution. Conclusions The rate for successful organ donation and conversion after citizen's death is low in Wuxi District. The organ donation work networks in local areas should be established. And organ donation promotion efforts and skills training for coordinators should be developed. -
表 1 器官捐献成功者的器官捐献情况
Table 1. Organ donation status of successful organ donors(x+s)
参数 大器官和组织捐献个数① t值/F值 P值 大器官捐献个数② t值/F值 P值 性别 0.084 0.934 0.594 0.556 男 4.2± 1.6 3.5± 1.1 女 4.2± 1.6 3.2± 1.0 年龄(岁) 2.964 0.046 0.609 0.614 <18 5.8± 1.6 3.8± 1.6 18~34 3.3± 1.4 3.0± 1.2 35~49 4.1± 1.1 3.4± 0.8 ≥50 4.2± 1.9 3.6± 1.1 死亡原因 0.856 0.434 1.073 0.353 颅脑外伤 3.9± 1.4 3.2± 0.9 脑卒中 4.5± 1.8 3.6± 1.3 其他 4.8± 1.3 3.8± 1.0 籍贯 0.961 0.343 0.466 0.644 江苏省内 4.5± 1.5 3.5± 0.9 外省 4.0± 1.6 3.3± 1.2 文化程度 1.027 0.369 0.833 0.443 小学及以下 4.1± 1.0 3.1± 0.8 初中 4.6± 1.8 3.7± 1.3 高中及以上 3.8± 1.4 3.3± 0.9 职业 0.084 0.094 0.208 0.813 工人 4.2± 1.5 3.4± 0.9 学生 5.3± 1.9 3.7± 1.5 其他 3.6± 1.3 3.3± 1.2 注:①包括心脏、肝脏、肾脏、肺脏、小肠和角膜。
②包括心脏、肝脏、肾脏、肺脏和小肠。 -
[1] 黄洁夫, 叶啟发.建立中国模式的公民器官捐献体系, 为人民群众提供高质量的器官移植医疗服务[J].武汉大学学报(医学版), 2017, 38(6):861-865. DOI: 10.14188/j.1671-8852.2017.06.001.HUANG JF, YE QF. Establishing the Chinese model of organ donation and transplant system to provide high level ethical transplant service for the Chinese people[J]. Med J Wuhan Univ, 2017, 38(6):861-865. DOI:10.14188/ j.1671-8852.2017.06.001. [2] 中国人体器官捐献管理中心.捐献完成登记捐献志愿登记[EB/OL]. [2019-06-24].http://www.rcsccod.cn/. [3] 人民日报海外版.2018年我国器官捐献位居世界第二移植质量不断提升[N/OL]. [2019-12-17].https://China. huanqiu.com/article/9Cakrnkon5H?qq-pf-to=pcqq.discussion. [4] MATESANZ R, DOMÍNGUEZ-GIL B, COLL E, et al. Spanish experience as a leading country: what kind of measures were taken? [J]. Transpl Int, 2011, 24(4):333- 343. DOI: 10.1111/j.1432-2277.2010.01204.x. [5] U.S. Department of Health & Human Services. Organ procurement and transplantation network[EB/OL]. [2019-06-23].https://optn.transplant.hrsa.gov/data/viewdata-reports/national-data/#. [6] 董鹤, 方玉婷, 王丹, 等.国内外器官捐献现状与思考[J].护理学报, 2017, 24(11):23-26.DOI:10.16460/j.issn 1008-9969.2017.11.023.DONG H, FANG YT, WANG D, et al. Current status and thinking of organ donation at home and abroad [J]. J Nurs, 2017, 24(11):23-26. DOI:10.16460/j.issn 1008-9969.2017.11.023. [7] 国家卫生和计划生育委员会脑损伤质控评价中心.脑死亡判定标准与技术规范(成人质控版)[J].中华神经科杂志, 2013, 46(9):637-640.DOI:10.3760/cma.j.issn. 1006-7876.2013.09.015.Brain Injury Evaluation Quality Control Centre of National Health and Family Planning Commission. Judgment standard and technical specification of brain death (adult quality control version)[J]. Chin J Neurol, 2013, 46(9):637-640. DOI: 10.3760/cma.j.issn.1006-7876.2013.09.015. [8] 国家卫生和计划生育委员会脑损伤质控评价中心.脑死亡判定标准与技术规范(儿童质控版)[J].中华儿科杂志, 2014, 52(10):756-759. DOI: 10.3760/cma. j.issn.0578-1310.2014.10.008.Brain Injury Evaluation Quality Control Centre of National Health and Family Planning Commission. Judgment standard and technical specification of brain death (child quality control version)[J]. Chin J Pediatri, 2014, 52(10):756-759. DOI: 10.3760/cma.j.issn.0578-1310.2014.10.008. [9] 国家卫生健康委员会. 2017年国家医疗服务与质量安全报告[M].北京:科学技术文献出版社, 2018. [10] 邓斐文, 陈焕伟, 甄作均.公民逝世后器官捐献供肝肝移植单中心经验总结[J].器官移植, 2017, 8(6):435- 439. DOI: 10.3969/j.issn.1674-7445.2017.06.005.DENG FW, CHEN HW, ZHEN ZJ, et al. Liver transplantation from donor liver of organ donation after citizen's death: a single center experience[J]. Organ Transplant, 2017, 8(6):435-439. DOI:10.3969/j.issn.1674- 7445. 2017.06.005. [11] 范宁, 李志强, 郭源, 等.公民逝世后器官捐献原位劈离式肝移植单中心经验[J/CD].中华移植杂志(电子版), 2017, 11(4): 216-220.DOI:10.3877/cma.j.issn.1674- 3903. 2017.04.005.FAN N, LI ZQ, GUO Y, et al. In-suit split liver transplantation from organ donation after citizen's death in China: a single-center experience[J/CD].Chin J Transplant (Electr Vers), 2017, 11(4): 216-220.DOI:10.3877/cma.j.issn.1674- 3903. 2017.04.005. [12] 无锡日报.无锡人均期望寿命82.24岁[N/OL]. [2017- 06-22].http://epaper.wxrb.com/paper/wxrb/html/2017- 06/22/content_646978.htm. [13] WEISS JH, KEEL I, IMMER FF, et al. Swiss Monitoring of Potential Organ Donors (SwissPOD): a prospective 12-month cohort study of all adult ICU deaths in Switzerland[J]. Swiss Med Wkly, 2014, 144:w14045. DOI: 10.4414/smw.2014.14045. [14] 赵纪强, 霍枫, 李鹏, 等.中国心脏死亡器官捐献工作发展及影响因素: 单中心经验[J/CD].中华移植杂志(电子版), 2017, 11(1): 32-36.DOI:10.3877/cma.j.issn. 1674-3903.2017.01.008.ZHAO JQ, HUO F, LI P, et al. Development and influence factors of Chinese organ donation after cardiac death: single-center experience[J/CD]. Chin J Transplant (Electr Vers), 2017, 11(1): 32-36. DOI:10.3877/cma.j.issn. 1674-3903.2017.01.008. [15] 贾丽娜, 肖奇贵, 杨勤玲, 等.西北地区公民逝世后器官捐献者家属捐献意愿影响因素分析[J].中国医学伦理学, 2019, 32(4):474-479. DOI:10.12026.j.issn. 1001- 8565.2019.04.11.JIA LN, XIAO QG, YANG QL, et al. A study of factors influencing family decision of organ donation after citizen's death in Northwest China[J]. Chin Med Ethic, 2019, 32(4):474-479. DOI:10.12026.j.issn.1001-8565. 2019.04.11. [16] YAN J, WANG Y, SHAO J, et al. Attitudes toward living organ donation and willingness to be a living organ donor among Chinese citizens in 3 cities[J]. Transplant Proc, 2018, 50(10):3065-3070. DOI: 10.1016/ j.transproceed.2018.06.042. [17] 耿子翔, 牛天赋, 杲舒畅, 等.烟台市居民器官捐献意愿影响因素调查分析及新宣传模式的构思[J].器官移植, 2018, 9(6):445-450.DOI: 10.3969/j.issn.1674-7445.2018.06.009.GEN ZX, NIU TF, GAO SC, et al. Investigation of influencing factors of residents' willingness to donate organs in Yantai City and conception of novel propaganda mode[J]. Organ Transplant, 2018, 9(6):445-450. DOI: 10.3969/j.issn.1674-7445.2018.06.009. [18] 黄伟, 叶啟发, 李育玮, 等.移植协调员在DCD工作中的角色和作用[J].医学与哲学, 2011, 32(20):62-64. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=yxyzx201120026HUANG W, YE QF, LI YW, et al. The role of transplantation coordinators in DCD work[J]. Med Philo, 2011, 32(20):62-64. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=yxyzx201120026 [19] SIMPKIN AL, ROBERTSON LC, BARBER VS, et al. Modifiable factors influencing relatives' decision to offer organ donation: systematic review[J]. BMJ, 2009, 338:b991. DOI: 10.1136/bmj.b991. [20] 中华医学会器官移植学分会.中国公民逝世后器官捐献流程和规范(2019版)[J].器官移植, 2019, 10(2):122- 127. DOI: 10.3969/j.issn.1674-7445.2019.02.003.Branch of Organ Transplantation of Chinese Medical Association. Process and specification of Chinese donation after citizen s death (2019 edition) [J]. Organ Transplant, 2019, 10(2):122-127. DOI:10.3969/j.issn. 1674-7445.2019.02.003. [21] ZHANG H, ZHENG J, LIU W, et al. Investigation and strategic analysis of public willingness and attitudes toward organ donation in East China[J]. Transplant Proc, 2015, 47(8):2419-2424. DOI: 10.1016/ j.transproceed.2015.09.011. [22] 张立民, 张玉平, 郭亚雄, 等.临床医学本科生对脑死亡认识的调查与分析[J].河北北方学院学报(自然科学版), 2017, 33(10):58-60.DOI:10.3969/j.issn.1673- 1492.2017.10.019.ZHANG LM, ZHANG YP, GUO YX, et al. Investigation and analysis of cognition for brain death in undergraduates majoring in clinical medicine[J]. J Hebei North Univ (Nat Sci Edit), 2017, 33(10):58-60. DOI: 10.3969/j.issn.1673-1492.2017.10.019. [23] 李小杉, 缪俊艳, 胡迪, 等.公民对脑死亡标准立法态度的现状调查[J].器官移植, 2020, 11(1):87-92. DOI: 10.3969/j.issn.1674-7445.2020.01.014.LI XS, MIU JY, HU D, et al. Investigation of current status of citizen's attitude to legislation of brain death criteria [J]. Organ Transplant, 2020, 11(1):87-92. DOI:10. 3969/j.issn.1674-7445.2020.01.014.
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