Noneligible Donors as a Strategy to Decrease the Organ Shortage
Noneligible Donors as a Strategy to Decrease the Organ Shortage
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DOI：
10.1111/ajt.14163
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发表时间：
2017-06-01
影响因子：
8.8
通讯作者：
Taner, C. B.
中科院分区：
文献类型：
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作者：
Croome, K. P.;Lee, D. D.;Taner, C. B.
器官采购组织（OPO）的绩效通常是通过器官采购程序的数量除以合格死亡人数（脑死亡[DBD]捐赠者年龄70岁）来评估的。本研究旨在调查58个供肝服务区（DSA）不合格供肝者比例的变化。2011年至2015年期间接受肝移植（LT）的患者来自器官共享标准移植分析和研究联合网络文件。比较了不合格和合格供体的LT。DSA显示不合格供肝者的比例差异很大，占总肝移植物的0%至19.6%。在移植计划中，使用的不合格肝脏供体的比例范围为0%至35.3%。在线性回归中，给定DSA中程序的终末期肝病匹配模型评分与相应DSA中使用的不合格供体比例之间无相关性（p = 0.14）。在许多业务方案组织中，不合格的捐助者仍然是一种利用不足的资源。政策的变化，开始跟踪不合格的捐助者和学习OPO有高不合格的捐助者的使用是潜在的战略，以提高认识和追求这些器官。
Organ procurement organization (OPO) performance is generally evaluated by the number of organ procurement procedures divided by the number of eligible deaths (donation after brain death [DBD] donors aged 70 years) is not tracked. The present study aimed to investigate the variability in the proportion of noneligible liver donors by the 58 donor service areas (DSAs). Patients undergoing liver transplant (LT) between 2011 and 2015 were obtained from the United Network for Organ Sharing Standard Transplant Analysis and Research file. LTs from noneligible and eligible donors were compared. The proportion of noneligible liver donors by DSA varied significantly, ranging from 0% to 19.6% of total liver grafts used. In transplant programs, the proportion of noneligible liver donors used ranged from 0% to 35.3%. On linear regression there was no correlation between match Model for End-Stage Liver Disease score for programs in a given DSA and proportion of noneligible donors used from the corresponding DSA (p = 0.14). Noneligible donors remain an underutilized resource in many OPOs. Policy changes to begin tracking noneligible donors and learning from OPOs that have high noneligible donor usage are potential strategies to increase awareness and pursuit of these organs.