Continuously Evaluating Performance in Deceased Donation: The Spanish Quality Assurance Program

被引：59
|
作者：
de la Rosa, G. [1 ]
Dominguez-Gil, B. [1 ]
Matesanz, R. [1 ]
Ramon, S. [1 ]
Alonso-Alvarez, J. [2 ]
Araiz, J. [3 ]
Choperena, G. [4 ]
Cortes, J. L. [5 ]
Daga, D. [6 ]
Elizalde, J. [7 ]
Escudero, D. [8 ]
Escudero, E. [9 ]
Fernandez-Renedo, C. [10 ]
Frutos, M. A. [11 ]
Galan, J. [12 ]
Getino, M. A.
Guerrero, F. [13 ]
Lara, M. [14 ]
Lopez-Sanchez, L. [15 ]
Macias, S. [16 ]
Martinez-Guillen, J. [17 ]
Masnou, N. [18 ]
Pedraza, S. [19 ]
Pont, T. [18 ]
Sanchez-Rodriguez, A. [19 ]
机构：
[1] Org Nacl Trasplantes, Madrid, Spain
[2] Hosp Basurto, Vizcaya, Spain
[3] Hosp Clin Lozano Blesa, Zaragoza, Spain
[4] Hosp Donostia, San Sebastian, Spain
[5] Hosp Albacete, Albacete, Spain
[6] Hosp Virgen de la Victoria, Malaga, Spain
[7] Hosp Navarra, Navarra, Spain
[8] Hosp Cent Asturias, Asturias, Spain
[9] Hosp Can Misses, Ibiza, Spain
[10] Castilla & Leon Reg Transplant Coordinat, Valladolid, Spain
[11] Hosp Carlos Haya, Malaga, Spain
[12] Hosp La Fe, E-46009 Valencia, Spain
[13] Hosp Torrecardenas, Almeria, Spain
[14] Hosp Rio Hortega, Valladolid, Spain
[15] Hosp Infanta Cristina, Badajoz, Spain
[16] Hosp Segovia, Segovia, Spain
[17] Hosp Vega Baja Orihuela, Alicante, Spain
[18] Hosp Valle De Hebron, Barcelona, Spain
[19] Hosp Puerta del Mar, Cadiz, Spain
来源：
AMERICAN JOURNAL OF TRANSPLANTATION | 2012年 / 12卷 / 09期
关键词：
donation after brain death; quality; tissue and organ donation and procurement; transplantation; INTENSIVE-CARE UNITS; ORGAN DONATION; NUMBER; DONORS; WALES; AUDIT;
D O I：
10.1111/j.1600-6143.2012.04138.x
中图分类号：
R61 [外科手术学];
学科分类号：
摘要：
The Spanish Quality Assurance Program applied to the process of donation after brain death entails an internal stage consisting of a continuous clinical chart review of deaths in critical care units (CCUs) performed by transplant coordinators and periodical external audits to selected centers. This paper describes the methodology and provides the most relevant results of this program, with information analyzed from 206,345 CCU deaths. According to the internal audit, 2.3% of hospital deaths and 12.4% of CCU deaths in Spain yield potential donors (clinical criteria consistent with brain death). Out of the potential donors, 54.6% become actual donors, 26% are lost due to medical unsuitability, 13.3% due to refusals to donation, 3.1% due to maintenance problems and 3% due to other reasons. Although the national pool of potential donors after brain death has progressively decreased from 65.2 per million population (pmp) in 2001 to 49 pmp in 2010, the number of actual donors after brain death has remained at about 30 pmp. External audits reveal that the number of actual donors could be 21.6% higher if all potential donors were identified and preventable losses avoided. We encourage other countries to develop similar comprehensive approaches to deceased donation performance.
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页码：2507 / 2513
页数：7
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