Professionalization of surgical abdominal organ recovery leading to an increase in pancreatic allografts accepted for transplantation in the Netherlands: a serial analysis
| Autor: | Hein Putter, Andrzej G Baranski, W. Kopp, Andries E. Braat, Hwai-Ding Lam, Alexander F. Schaapherder |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Certification medicine.medical_treatment 030230 surgery Pancreas transplantation Young Adult 03 medical and health sciences 0302 clinical medicine pancreas donor organ preservation and procurement medicine Humans pancreas transplantation Netherlands Retrospective Studies Transplantation business.industry donation Middle Aged Allografts Circulatory death Surgery Donation after brain death surgical procedures operative medicine.anatomical_structure Donation Tissue and Organ Harvesting 030211 gastroenterology & hepatology business Pancreas Body mass index |
| Zdroj: | Transplant International, 30(2), 117-123 |
| Popis: | Professional abdominal organ recovery with certification has been mandatory in the Netherlands since 2010. This study analyses the effects of certification (January 2010-September 2015) on pancreas transplantation and compares it to an era before certification (February 2002-May 2008) for surgical injuries and the number of pancreases transplanted. A total of 264 cases were analysed. Eighty-four recovered pancreases (31.8%) with surgically injuries were encountered. Forty-six of those were surgically salvaged for transplantation, resulting in a total of 226 (85.6%) being transplanted. It was found that certified surgeons recovered grafts from older donors (36.8 vs. 33.3; P = 0.021), more often from donation after circulatory death (DCD) donors (18% vs. 0%; P < 0.001) and had less surgical injuries (21.6% vs. 41.0%; P < 0.001). Certification (OR: 0.285; P < 0.001) and surgeons from a pancreas transplant centre (OR: 0.420; P = 0.002) were independent risk factors for surgical organ injury. Predictors for proceeding to the actual pancreas transplantation were a recovering surgeon from a pancreas transplantation centre (OR: 3.230; P = 0.003), certification (OR: 3.750; P = 0.004), donation after brain death (DBD) (OR: 8.313; P = 0.002) and donor body mass index (BMI) (OR: 0.851; P = 0.023). It is concluded that certification in abdominal organ recovery will limit the number of surgical injuries in pancreas grafts which will translate in more pancreases available for transplantation. |
| Databáze: | OpenAIRE |
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