Lung Focused Resuscitation at a Specialized Donor Care Facility Improves Lung Procurement Rates
Lung Focused Resuscitation at a Specialized Donor Care Facility Improves Lung Procurement Rates
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DOI：
10.1016/j.athoracsur.2017.12.009
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发表时间：
2018-05-01
影响因子：
4.6
通讯作者：
Puri, Varun
中科院分区：
文献类型：
--
作者：
Chang, Stephanie H.;Kreisel, Daniel;Puri, Varun
背景。大约 20% 的脑死亡供体需要获取用于移植的肺，这是肺移植广泛应用的主要障碍。我们研究了专门的供体护理机构的肺保护管理对脑死亡供体的肺获取率的影响。方法。我们当地的器官采购组织于2008年在独立的专门供体护理设施中制定了肺保护管理协议。使用前瞻性维护的数据库，将2001年至2007年（早期）的脑死亡捐献者与2009年至2016年（当前时期）的肺采购率和其他实体器官采购率进行比较。结果。研究期间脑死亡捐献者的数量总体增加（早期组，791；晚期组，1,333；p < 0.0001）。引入肺保护管理后，肺获取率（肺供体/所有脑死亡供体）显着改善（早期组，791 例中有 157 例 [19.8%]；当前组，1,333 例中有 452 例 [33.9%]；p < 0.0001）。研究期间，总体器官获取率（获取/捐献者的器官总数）也有所增加（早期组，3.5 个器官/捐献者；当前组，3.8 个器官/捐献者；p = 0.006）。结论。与传统管理相比，在专门的捐献者护理机构中对脑死亡捐献者进行肺保护管理与更高的肺利用率相关。该策略不会对多器官捐献者中其他器官的利用产生不利影响。 (C) 2018 年，胸外科医师协会。
Background. Lung procurement for transplantation occurs in approximately 20% of brain dead donors and is a major impediment to wider application of lung transplantation. We investigated the effect of lung protective management at a specialized donor care facility on lung procurement rates from brain dead donors.Methods. Our local organ procurement organization instituted a protocol of lung protective management at a freestanding specialized donor care facility in 2008. Brain dead donors from 2001 to 2007 (early period) were compared with those from 2009 to 2016 (current period) for lung procurement rates and other solid-organ procurement rates using a prospectively maintained database.Results. An overall increase occurred in the number of brain dead donors during the study period (early group, 791; late group, 1,333; p < 0.0001). The lung procurement rate (lung donors/all brain dead donors) improved markedly after the introduction of lung protective management (early group, 157 of 791 [19.8%]; current group, 452 of 1,333 [33.9%]; p < 0.0001). The overall organ procurement rate (total number of organs procured/donor) also increased during the study period (early group, 3.5 organs/donor; current group, 3.8 organs/donor; p = 0.006).Conclusions. Lung protective management in brain dead donors at a specialized donor care facility is associated with higher lung utilization rates compared with conventional management. This strategy does not adversely affect the utilization of other organs in a multiorgan donor. (C) 2018 by The Society of Thoracic Surgeons.