Improving organ procurement practices in Michigan.
Improving organ procurement practices in Michigan.
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DOI：
10.1111/j.1600-6143.2009.02784.x
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发表时间：
2009-10
期刊：
影响因子：
--
通讯作者：
Englesbe MJ
中科院分区：
文献类型：
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作者：
Lynch RJ;Mathur AK;Hundley JC;Kubus J;Pietroski RE;Mattice BJ;Punch JD;Englesbe MJ
为获取死者捐赠器官而进行的旅行与移植人员的风险有关。在许多情况下，多个小组参与一项行动。我们研究了全州的经验，以确定这种冗余需要多少额外的旅行，并为器官恢复生成替代模型。我们回顾了我们的器官采购组织在2002年至2008年期间与已故捐赠者手术的经验。旅行以采购队出发地和捐助医院之间的累计人英里数表示。使用最近的州内中心的胸部和腹部团队创建了一个最小旅行模型。第二种模式是将捐助者运送到专门的采购设施。使用这些模型重新计算了旅行距离，并从现行做法中推断出旅行方式和费用。在研究的654例胸部和1469例腹部供体中，胸部团队的平均旅行为1066人英里，腹部团队为550人英里。胸部和腹部器官的平均移动距离分别为223英里和142英里。这两种假设模型都显示，与历史数据相比，团队旅行和对航空运输的依赖减少，成本和器官运输时间有利。总之，我们发现，在目前的做法，这可能会得到缓解，使用新的模式为捐助者采购显着的效率低下。
Travel to procure deceased donor organs is associated with risk to transplant personnel. In many instances, multiple teams are present for a given operation. We studied our statewide experience to determine how much excess travel this redundancy entails, and generated alternate models for organ recovery. We reviewed our organ procurement organization’s experience with deceased donor operations between 2002 and 2008. Travel was expressed as cumulative person-miles between procurement team origin and donor hospital. A model of minimal travel was created, using thoracic and abdominal teams from the closest in-state center. A second model involved transporting donors to a dedicated procurement facility. Travel distance was recalculated using these models, and mode and cost of travel extrapolated from current practices. In 654 thoracic and 1469 abdominal donors studied, mean travel for thoracic teams was 1066 person-miles, and for abdominal teams was 550 person-miles. The mean distance traveled by thoracic and abdominal organs was 223 miles and 142 miles, respectively. Both hypothetical models showed reductions in team travel and reliance on air transport, with favorable costs and organ transport times compared to historical data. In summary, we found significant inefficiency in current practice, which may be alleviated using new paradigms for donor procurement.