The Riskiest Job in Medicine: Transplant Surgeons and Organ Procurement Travel
The Riskiest Job in Medicine: Transplant Surgeons and Organ Procurement Travel
复制标题
DOI：
10.1111/j.1600-6143.2009.02774.x
复制
发表时间：
2009-10-01
影响因子：
8.8
通讯作者：
Merion, R. M.
中科院分区：
文献类型：
--
作者：
Englesbe, M. J.;Merion, R. M.
由于与器官采购有关的旅行的紧迫性，移植外科医生面临工作场所的风险。一项回顾性队列研究使用了来自移植接受者科学登记处和国家运输安全委员会的数据。对美国移植外科医生协会的成员进行了一项基于网络的调查。调查回应率为38%（281/747）。15%的受访者报告发生了≥ 1起与采购有关的旅行事故;外科医生报告了61起事故和11人死亡。26%的事故使用航空旅行，56%的事故涉及航空旅行。据估计，在器官采购航班上旅行的死亡风险比定期商业航班高出1000倍。80.8%的人报告涉及“险些发生事故”。只有16%的受访者表示在旅行时感到“非常安全”。由地理上最近的移植中心采购器官将使肺、心脏、肝脏和胰腺采购的航空旅行（>100海里）分别减少35%、43%、31%和49%（p < 0.0001）。在器官获取和移植网络的每个区域都观察到了这些减少。虽然这些数据有重要的局限性，但它们表明器官采购旅行与重大风险相关。需要改进器官采购旅行。
Transplant surgeons are exposed to workplace risk due to the urgent nature of travel related to organ procurement. A retrospective cohort study was completed using data from the Scientific Registry of Transplant Recipients and the National Transportation Safety Board. A web-based survey was administered to members of the American Society of Transplant Surgeons. The survey response rate was 38% (281/747). Involvement in >= 1 procurement-related travel accident was reported by 15% of respondents; surgeons reported 61 accidents and 11 fatalities. Air travel was used in 26% of procurements and was involved in 56% of accidents. The risk of fatality while traveling on an organ procurement flight was estimated to be 1000 times higher than scheduled commercial flight. Involvement in a 'near miss accident' was reported by 80.8%. Only 16% of respondents reported feeling 'very safe' while traveling. Procurement of organs by the geographically closest transplant center would have reduced the need for air travel (>100 nautical miles) for lung, heart, liver and pancreas procurement by 35%, 43%, 31% and 49%, respectively (p < 0.0001). These reductions were observed in each Organ Procurement and Transplantation Network region. Though these data have important limitations, they suggest that organ procurement travel is associated with significant risk. Improvements in organ procurement travel are needed.