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Rebecca R. Goff Amber R. Wilk Alice E. Toll Maureen A. McBride David K. Klassen 《American journal of transplantation》2021,21(6):2100-2112
COVID-19 has been sweeping the globe, hitting the United States particularly hard with a state of emergency declared on March 13, 2020. Transplant hospitals have taken various precautions to protect patients from potential exposure. OPTN donor, candidate, and transplant data were analyzed from January 5, 2020 to September 5, 2020. The number of new waiting list registrations decreased, with the Northeast seeing over a 50% decrease from the week of 3/8 versus the week of 4/5. The national transplant system saw near cessation of living donor transplantation (−90%) from the week of 3/8 to the week of 4/5. Similarly, deceased donor kidney transplant volume dropped from 367 to 202 (−45%), and other organs saw similar decreases: lung (−70%), heart (−43%), and liver (−37%). Deceased donors recovered dropped from 260 to 163 (−45%) from 3/8 compared to 4/5, including a 67% decrease for lungs recovered. The magnitude of this decrease varied by geographic area, with the largest percent change (−67%) in the Northeast. Despite the pandemic, discard rates across organ has remained stable. Although the COVID-19 pandemic continues to evolve, OPTN data show recent evidence of stabilization, an indication that an early recovery of the number of living and deceased donors and transplants has ensued. 相似文献
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质量保证是器官获取组织(OPO)的责任,创建OPO质量管理体系是高质量开展人体器官捐献工作面临的新任务。当前我国OPO质量管理中存在着缺乏完善的管理机构、规范的管理流程、科学的评价指标、高素质的专业人才和浓厚的安全文化氛围等问题,有必要从思想观念转变、质量管理体系建设和过程实施管理等3个方面,紧密结合OPO的实际状况,参照国际通用质量管理体系标准进行顶层设计,更需要OPO管理者充分发挥领导作用,确保OPO在质量管理体系的持续改进中高效运行。 相似文献
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关于规范器官获取组织流程的思考 总被引:1,自引:0,他引:1
近年来,中国的器官移植事业发展较快,但由于缺乏系统规范的管理体系,衍生出了一系列社会、伦理、法律等方面的问题。通过分析我国器官捐献与获取现状以及所存在的问题,提示应采取及时发现潜在案例、判定生命状态、规范报批捐献手续、维护脏器功能、获取捐献器官、安抚供者家属、分配捐献器官等一系列措施来完善器官获取组织流程,以推进我国器官移植事业的健康长久发展。 相似文献
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A. B. Massie E. K. H. Chow C. E. Wickliffe X. Luo S. E Gentry D. C. Mulligan D. L. Segev 《American journal of transplantation》2015,15(3):659-667
In June 2013, a change to the liver waitlist priority algorithm was implemented. Under Share 35, regional candidates with MELD ≥ 35 receive higher priority than local candidates with MELD < 35. We compared liver distribution and mortality in the first 12 months of Share 35 to an equivalent time period before. Under Share 35, new listings with MELD ≥ 35 increased slightly from 752 (9.2% of listings) to 820 (9.7%, p = 0.3), but the proportion of deceased‐donor liver transplants (DDLTs) allocated to recipients with MELD ≥ 35 increased from 23.1% to 30.1% (p < 0.001). The proportion of regional shares increased from 18.9% to 30.4% (p < 0.001). Sharing of exports was less clustered among a handful of centers (Gini coefficient decreased from 0.49 to 0.34), but there was no evidence of change in CIT (p = 0.8). Total adult DDLT volume increased from 4133 to 4369, and adjusted odds of discard decreased by 14% (p = 0.03). Waitlist mortality decreased by 30% among patients with baseline MELD > 30 (SHR = 0.70, p < 0.001) with no change for patients with lower baseline MELD (p = 0.9). Posttransplant length‐of‐stay (p = 0.2) and posttransplant mortality (p = 0.9) remained unchanged. In the first 12 months, Share 35 was associated with more transplants, fewer discards, and lower waitlist mortality, but not at the expense of CIT or early posttransplant outcomes. 相似文献
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D. E. Stewart S. M. Tlusty K. H. Taylor R. S. Brown H. N. Neil D. K. Klassen J. A. Davis T. M. Daly P. C. Camp A. M. Doyle 《American journal of transplantation》2015,15(12):3123-3133
Analysis and dissemination of transplant patient safety data are essential to understanding key issues facing the transplant community and fostering a “culture of safety.” The Organ Procurement and Transplantation Network's (OPTN) Operations and Safety Committee de‐identified safety situations reported through several mechanisms, including the OPTN's online patient safety portal, through which the number of reported cases has risen sharply. From 2012 to 2013, 438 events were received through either the online portal or other reporting pathways, and about half were self‐reports. Communication breakdowns (22.8%) and testing issues (16.0%) were the most common types. Events included preventable errors that led to organ discard as well as near misses. Among events reported by Organ Procurement Organization (OPOs), half came from just 10 of the 58 institutions, while half of events reported by transplant centers came from just 21 of 250 institutions. Thirteen (23%) OPOs and 155 (62%) transplant centers reported no events, suggesting substantial underreporting of safety‐related errors to the national database. This is the first comprehensive, published report of the OPTN's safety efforts. Our goals are to raise awareness of safety data recently reported to the OPTN, encourage additional reporting, and spur systems improvements to mitigate future risk. 相似文献