Specialized Donor Care Facility Model and Advances in Management of Thoracic Organ Donors.
Specialized Donor Care Facility Model and Advances in Management of Thoracic Organ Donors.
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DOI：
10.1016/j.athoracsur.2020.12.026
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
Puri V
中科院分区：
文献类型：
--
作者：
Bery A;Marklin G;Itoh A;Kreisel D;Takahashi T;Meyers BF;Nava R;Kozower BD;Shepherd H;Patterson GA;Puri V
供体心脏和肺更容易受到脑死亡后发生的炎症生理变化的影响。先前的研究表明，对潜在器官捐献者的协议化管理可以恢复最初被认为不可接受的捐献器官。在这篇综述中，我们讨论了捐助者管理模式的进展，特别注意专门的捐助者护理设施（SDCF）模式。此外，我们还回顾了优化供体胸部器官和提高胸部移植器官产量的具体策略。我们通过检索Pubmed数据库中与器官供体管理模式相关的MeSH术语进行了文献综述。我们还与当地器官采购组织进行了沟通，以收集已发表和未发表的第一手信息。SDCF模式已被证明可以提高器官捐献者管理和采购的效率，同时降低成本，最大限度地减少旅行及其相关风险。肺保护性通气、肺不张复张和激素治疗（例如，糖皮质激素和T3/T4）与改善的肺利用率相关。基于每搏输出量的容量复苏与改善的心脏利用率相关，而评估激素治疗的研究（例如，糖皮质激素和T3/T4）显示出不同的结果。缺乏高质量的前瞻性证据导致器官采购组织之间的实践相互冲突，最佳实践仍然存在争议。未来的研究应集中在前瞻性，随机调查，以评估供体管理策略。SDCF模式促进了一个鼓励学术探究的协作环境，是这些调查的理想环境。
Donor hearts and lungs are more susceptible to the inflammatory physiologic changes that occur after brain death. Prior investigations have shown that protocolized management of potential organ donors can rehabilitate donor organs that are initially deemed unacceptable. In this review, we discuss advances in donor management models with particular attention to the specialized donor care facility (SDCF) model. In addition, we review specific strategies to optimize donor thoracic organs and improve organ yield in thoracic transplantation. We performed a literature review by searching the Pubmed database for MeSH terms associated with organ donor management models. We also communicated with our local organ procurement organization to gather published and unpublished information first-hand. The SDCF model has been shown to improve the efficiency of organ donor management and procurement while reducing costs and minimizing travel and its associated risks. Lung protective ventilation, recruitment of atelectatic lung, and hormone therapy (e.g., glucocorticoids and T3/T4) are associated with improved lung utilization rates. Stroke volume-based volume resuscitation is associated with improved heart utilization rates, while studies evaluating hormone therapy (e.g., glucocorticoids and T3/T4) have shown variable results. Lack of high-quality prospective evidence results in conflicting practices across organ procurement organizations and best practices remain controversial. Future studies should focus on prospective, randomized investigations to evaluate donor management strategies. The SDCF model fosters a collaborative environment that encourages academic inquiry and is an ideal setting for these investigations.
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影响因子：
2.9
作者：
de Boer JD;Van der Bogt KEA;Putter H;Ooms-de Vries KM;Haase-Kromwijk BJJM;Pol RA;De Jonge J;Dejong CHC;Nijboer WM;Van der Vliet JA;Braat AE
通讯作者：
Braat AE
影响因子：
8.8
作者：
Dimopoulou, I;Tsagarakis, S;Roussos, C
通讯作者：
Roussos, C
影响因子：
8.8
作者：
Doyle, M. B. M.;Vachharajani, N.;Chapman, W. C.
通讯作者：
Chapman, W. C.
影响因子：
8.8
作者：
Englesbe, M. J.;Merion, R. M.
通讯作者：
Merion, R. M.
影响因子：
8.8
作者：
Abecassis, M.
通讯作者：
Abecassis, M.