Organ Donor Recovery Performed at an Organ Procurement Organization-Based Facility Is an Effective Way to Minimize Organ Recovery Costs and Increase Organ Yield
Organ Donor Recovery Performed at an Organ Procurement Organization-Based Facility Is an Effective Way to Minimize Organ Recovery Costs and Increase Organ Yield
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DOI：
10.1016/j.jamcollsurg.2015.12.032
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发表时间：
2016-04-01
影响因子：
5.2
通讯作者：
Chapman, William C.
中科院分区：
文献类型：
--
作者：
Doyle, Majella;Subramanian, Vijay;Chapman, William C.
背景：随着国家重新划分选区，器官捐赠的新纪元正在被提出。有了这些提议，器官获取的成本估计将增加一倍以上。传统上，器官回收发生在捐赠者医院的环境中，产生额外的医院费用。这项研究的目的是确定在器官采购组织(OPO)机构进行的捐赠者回收的器官回收成本和器官产量。研究设计：2001年，我们建立了OPO机构，并于2008年开始在宣布脑死亡时迅速转移捐赠者。在每个捐赠者的基础上计算了OPO捐赠者和住院费用。结果：2009年1月至2014年12月，963例心脏死亡供者进行了器官回收和移植。766例(79.5%)供者在宣布脑死亡后8.6h(0.6h至23.6h)被转移至OPO机构。当捐赠者被转移到OPO设施时，捐赠者恢复成本降低了51%(OPO恢复16,153美元与医院恢复33,161美元；p<；0.0001)。口服避孕药恢复的捐赠者的器官产量比医院恢复的捐赠者好27.5%(3.43个器官)，而医院恢复的捐赠者的器官产量为2.69%(p<；0.0001)。我们的OPO标准供体器官产量比全国平均水平高6%(3.92vs3.7全国；p=0.012)，扩展标准供体器官产量高18%(2.2vs1.87全国；p=0.03)。结论：OPO供体器官回收设施提高了效率和器官产量，降低了成本，并将器官获取费用降至最低。随着我们面临更广泛的共享、更高的效率和成本的新考虑。而且应该考虑器官的使用。(J am Coll Surg 2016；222：591-600。(C)2016年由美国外科医师学会颁发。由Elsevier Inc.出版。保留所有权利。)
BACKGROUND: A new era in organ donation with national redistricting is being proposed. With these proposals, costs of organ acquisition are estimated to more than double. Traditionally, organ recoveries occur in the donor hospital setting, incurring premium hospital expenses. The aim of the study was to determine organ recovery costs and organ yield for donor recoveries performed at an organ procurement organization (OPO) facility.STUDY DESIGN: In 2001, we established an OPO facility and in 2008 began transferring the donor expeditiously when brain death was declared. The OPO donor and hospital costs on a per donor basis were calculated. Donation after cardiac death donors cannot be transferred and were included in the hospital cost analysis.RESULTS: From January 2009 to December 2014, nine hundred and sixty-three donors originating in our OPO had organs recovered and transplanted. Seven hundred and sixty-six (79.5%) donors were transferred to the OPO facility 8.6 hours (range 0.6 to 23.6 hours) after declaration of brain death. Donor recovery cost was 51% less when donors were transferred to the OPO facility ($16,153 OPO recovery vs $33,161 hospital recovery; p < 0.0001). Organ yield was 27.5% better (3.43 organs) from OPO-recovered donors vs an organ yield of 2.69 from hospital-recovered donors (p < 0.0001). Standard criteria donor organ yield from our OPO was 6% higher than the national average (3.92 vs 3.7 nationally; p = 0.012) and expanded criteria donor organ yield was 18% higher (2.2 vs 1.87 nationally; p = 0.03).CONCLUSIONS: An OPO facility for donor organ recovery increases efficiency and organ yield, reduces costs, and minimizes organ acquisition charge. As we face new considerations with broader sharing, increased efficiencies, cost. and organ use should be considered. (J Am Coll Surg 2016; 222: 591-600. (C) 2016 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.)