Discussion on the experience of organ donation after citizen's death under COVID-19 epidemic
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摘要:
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。 Abstract: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 infectionprevention 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 effectivelyreduce the risk of COVID-19 infection and carry out organ donation after citizen' s death in a safe and organized manner. -
图 1 疫情期间潜在供者诊疗流程图
Figure 1. Flow chart of diagnosis and treatment of potential organ donor during the epidemic
图 2 例5患者与新冠肺炎患者胸部CT结果比较
注：A图为我院1例新冠肺炎患者胸部CT典型表现；B图和C图分别为例5患者入院时和同意捐献后的胸部CT表现
Figure 2. Comparison of chest CT results between case 5 patient and a patient with novel coronavirus pneumonia
表 1 5例成功捐献者的临床资料
Table 1. Clinical data of 5 cases of successful donation
例序 性别 年龄（岁） 市（县）① 定点医院② 诊断 住院时间（d） 胸部CT 血白细胞 血淋巴细胞 体温 1 女 5 否 否 脑炎 15 无异常 偏高 偏低 早期中高热为主 2 男 41 有 是 脑出血 3 无异常 偏高 偏低 术后低热 3 女 64 否 否 脑出血 3 无异常 偏高 正常 低热为主 4 男 67 有 否 脑出血 9 吸入性肺炎 偏高 偏低 偶有低热 5 男 55 有 否 脑出血 4 无异常 偏高 正常 术后以中低热为主 注：①市（县）指患者发病时所在市或县14 d内有否确诊或可疑新冠肺炎病例。
②定点医院指患者是否来自广西指定新冠肺炎定点救治医院。
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