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Crit Care Med:延迟转诊导致循环死亡后器官捐赠机会错失!

2017-04-05 xing.T MedSci原创

计划停止生命维持治疗2小时内死亡的适合医疗器官捐献的患者数量几乎是实际器官捐赠者数量的六倍,潜在器官捐献者丢失的主要原因是在计划停止生命维持治疗之时或之后进行的延迟转诊所致。重症监护小组没有履行他们的道德责任,来承认即将到来的死亡,并适当地转诊潜在的器官捐赠者到当地器官库。

在过去十年中,美国和加拿大的器官捐赠和移植率稳步上升,主要是由于循环死亡后器官捐赠人数的显著增加所致。然而,等待实体器官移植的患者数量仍远高于每年移植器官的数量。近日,危重病医学领域权威杂志Critical Care Medicine上发表了一篇研究文章,该研究的目的是明确进一步增加器官捐献率的潜在可能。

该研究为回顾性队列研究,以省级器官库为基础。在2013年4月1日至2015年3月31日期间,以安大略省指定捐赠医院内死亡的患者为研究对象。

在1407例计划停止生命维持治疗的患者死亡后,54%(n=760)的患者在医学上适合循环死亡后进行器官捐献。在与438例死者的亲属接洽后,同意器官捐献率达到47.5%。共有119例患者成为实际器官捐献者。只有66.2%(n=503)合适的患者被适当转诊,由于转诊始于停止生命维持治疗之后或根本没有进行转诊,使其亲属不能接洽进行器官捐赠,导致丢失了251例潜在的器官捐助者。

计划停止生命维持治疗2小时内死亡的适合医疗器官捐献的患者数量几乎是实际器官捐赠者数量的六倍,潜在器官捐献者丢失的主要原因是在计划停止生命维持治疗之时或之后进行的延迟转诊所致。重症监护小组没有履行他们的道德责任,来承认即将到来的死亡,并适当地转诊潜在的器官捐赠者到当地器官库。

原始出处:

Krmpotic, Kristina, et al. Delayed Referral Results in Missed Opportunities for Organ Donation After Circulatory Death.Critical Care Medicine.2017. http://journals.lww.com/ccmjournal/Abstract/publishahead/Delayed_Referral_Results_in_Missed_Opportunities.96662.aspx

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    2017-10-10 kalseyzl
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    2017-04-06 飛歌

    学习了很有用

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1648588, encodeId=3046164858854, content=<a href='/topic/show?id=afa493462ec' target=_blank style='color:#2F92EE;'>#转诊#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93462, encryptionId=afa493462ec, topicName=转诊)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=471123610769, createdName=kalseyzl, createdTime=Tue Oct 10 22:21:00 CST 2017, time=2017-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1756935, encodeId=2af41e5693501, content=<a href='/topic/show?id=db7856538ee' target=_blank style='color:#2F92EE;'>#捐赠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56538, encryptionId=db7856538ee, topicName=捐赠)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ce7f37274706, createdName=ms1692212821629096, createdTime=Wed Nov 15 05:21:00 CST 2017, time=2017-11-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1973893, encodeId=21d719e38934b, content=<a href='/topic/show?id=49384029ee2' target=_blank style='color:#2F92EE;'>#器官捐赠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=40297, encryptionId=49384029ee2, topicName=器官捐赠)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/71tKRib0PibveVjnEa7tPLMaCzoKicFlKSEOzRTGf4wNvDV54kJyNx1ott1D5Xp5gRu7IwUia77oN0YFdffvQMu6Ug/132, createdBy=9e302500146, createdName=ms49895894946433513521, createdTime=Sun May 21 08:21:00 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607363, encodeId=ce77160e363dd, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Apr 07 12:21:00 CST 2017, time=2017-04-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185471, encodeId=c5661854e1fc, content=学习了很有用, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Thu Apr 06 07:34:43 CST 2017, time=2017-04-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=185454, encodeId=acf51854545e, content=阅读了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Thu Apr 06 06:39:52 CST 2017, time=2017-04-06, status=1, ipAttribution=)]
    2017-04-06 刘煜

    阅读了谢谢分享

    0

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