PDF(Pubmed)
Abstract：
UNASSIGNED: Despite the discrepancy between demand and availability of organs for transplantation, controlled circulatory death donation has not been implemented in Portugal. This study aimed to estimate the potential increase in organ donation from implementing such a program.
UNASSIGNED: All deceased patients within the intensive care medicine department at Centro Hospitalar Universitário de São João, throughout the year 2019, were subjected to retrospective analysis. Potential gain was estimated comparing the results with the number of donors and organs collected during the same period at this hospital center. Differences in variables between groups were assessed using t tests for independent samples or Mann-Whitney U tests for continuous variables, and chi-squared tests were used for categorical variables.
UNASSIGNED: During 2019, 152 deaths occurred after withdrawal of life-sustaining therapies, 10 of which would have been potentially eligible for donation after controlled circulatory death. We can anticipate a potential increase of 10 prospective donors, a maximum 21% growth in yearly transplantation activity, with a greater impact on kidney transplantation. For most patients, the time between withdrawal of organ support and death surpassed 120 minutes, an outcome explained by variations in withdrawal of life-sustaining measures and insufficient clinical records, underestimating the potential for controlled circulatory arrest donation.
UNASSIGNED: This study effectively highlights public health benefits of controlled circulatory arrest donation. Legislation allowing donation through this method represents a social gain and enables patients who will never meet brain death criteria to donate organs as part of the end-of-life process in intensive care medicine, within a framework of complete ethical alignment.
UNASSIGNED: All deceased patients within the intensive care medicine department at Centro Hospitalar Universitário de São João, throughout the year 2019, were subjected to retrospective analysis. Potential gain was estimated comparing the results with the number of donors and organs collected during the same period at this hospital center. Differences in variables between groups were assessed using t tests for independent samples or Mann-Whitney U tests for continuous variables, and chi-squared tests were used for categorical variables.
UNASSIGNED: During 2019, 152 deaths occurred after withdrawal of life-sustaining therapies, 10 of which would have been potentially eligible for donation after controlled circulatory death. We can anticipate a potential increase of 10 prospective donors, a maximum 21% growth in yearly transplantation activity, with a greater impact on kidney transplantation. For most patients, the time between withdrawal of organ support and death surpassed 120 minutes, an outcome explained by variations in withdrawal of life-sustaining measures and insufficient clinical records, underestimating the potential for controlled circulatory arrest donation.
UNASSIGNED: This study effectively highlights public health benefits of controlled circulatory arrest donation. Legislation allowing donation through this method represents a social gain and enables patients who will never meet brain death criteria to donate organs as part of the end-of-life process in intensive care medicine, within a framework of complete ethical alignment.
摘要：
■尽管移植器官的需求和可获得性之间存在差异，葡萄牙尚未实施受控循环死亡捐赠。这项研究旨在评估实施此类计划可能增加的器官捐赠。
■圣若昂大学中心医院重症监护医学科内的所有已故患者，2019年全年进行回顾性分析。将结果与同一时期在该医院中心收集的供体和器官的数量进行比较，估计了潜在的收益。组间变量的差异采用独立样本的t检验或连续变量的Mann-WhitneyU检验进行评估，分类变量采用卡方检验。
■在2019年期间，有152人在停药后死亡。其中10人在受控循环死亡后可能有资格捐赠。我们可以预计潜在的10个潜在捐助者的增加，每年移植活动的最高增长率为21%，对肾移植有较大影响。对于大多数患者来说,器官支持退出和死亡之间的时间超过120分钟，结果是由于撤回维持生命的措施和临床记录不足而引起的变化，低估了控制循环停止捐赠的可能性。
■这项研究有效地强调了控制性停循环捐赠的公共卫生益处。允许通过这种方法进行捐赠的立法代表了一种社会利益，并使永远不会符合脑死亡标准的患者能够捐赠器官，作为重症监护医学中生命终结过程的一部分，在一个完全的伦理协调的框架内。
■圣若昂大学中心医院重症监护医学科内的所有已故患者，2019年全年进行回顾性分析。将结果与同一时期在该医院中心收集的供体和器官的数量进行比较，估计了潜在的收益。组间变量的差异采用独立样本的t检验或连续变量的Mann-WhitneyU检验进行评估，分类变量采用卡方检验。
■在2019年期间，有152人在停药后死亡。其中10人在受控循环死亡后可能有资格捐赠。我们可以预计潜在的10个潜在捐助者的增加，每年移植活动的最高增长率为21%，对肾移植有较大影响。对于大多数患者来说,器官支持退出和死亡之间的时间超过120分钟，结果是由于撤回维持生命的措施和临床记录不足而引起的变化，低估了控制循环停止捐赠的可能性。
■这项研究有效地强调了控制性停循环捐赠的公共卫生益处。允许通过这种方法进行捐赠的立法代表了一种社会利益，并使永远不会符合脑死亡标准的患者能够捐赠器官，作为重症监护医学中生命终结过程的一部分，在一个完全的伦理协调的框架内。
