Organisational structure of liver transplantation in the UK

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• 作者：James Neuberger
• 关键词：Liver transplantation ; Organ donation ; Organ retrieval ; UK
• 刊名：Langenbeck's Archives of Surgery
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：400
• 期：5
• 页码：559-566
• 全文大小：373 KB
• 参考文献：1.Organs for transplants: a report from the Organ Donation Task Force. http://?www.?nhsbt.?nhs.?uk/?to2020/?resources/?Organsfortranspl?antsTheOrganDono?rTaskForce1strep?ort.?pdf . Accessed 9 March 2015
  2.Taking Organ Transplantation to 2020. www.?nhsbt.?nhs.?uk/?to2020/-/span>
  3.Barber K, Madden S, Allen J, Collett D, Neuberger J, Gimson AE, United Kingdom Liver Transplant Selection and Allocation Working Party (2011) Elective liver transplant mortality: development of a United Kingdom end-stage liver disease score. Transplantation 92:469-76PubMed View Article
  4.Newsletter Transplant International. Figures on Donation and Transplantation 2012. 18:1.2013
  5.Johnson R, Bradbury LL, Martin K, Neuberger J, UK Transplant Registry (2014) Organ donation and transplantation in the UK—the last decade: a report from the UK national transplant registry. Transplantation 97(Suppl 1):S1–S27
  6.Neuberger J, Madden S, Collett D (2010) Review of methods for measuring and comparing center performance after organ transplantation. Liver Transpl 16:1119-128PubMed View Article
  7.Saidi RF, Razavi M, Cosimi AB, Ko DS (2015) Competition in liver transplantation: helpful or harmful? Liver Transpl 21:145-50PubMed View Article
  8.Halldorson JB, Paarsch HJ, Didge JL, Segre AM, Lai J, Roberts JP (2013) Center competition and outcomes following liver transplantation. Liver Transpl 19:96-04PubMed Central PubMed View Article
  9.Macomber CW, Shaw JJ, Santry H, Saidi RF, Jabbour N, Tseng JF, Bozorgzadeh A, Shah SA (2012) Center volume and resource consumption in liver transplantation. HPB 14:554-59PubMed Central PubMed View Article
  10.Guba M (2014) Center volume, competition and outcome in German liver transplant centers. Transp Res 3:6View Article
  11.Nijboer A, Ulrich F, Bechstein WO, Schnitzbauer AA (2014) Volume and outcome relation in German liver transplant centers: what lessons can be learned? Transpl Res 3:4View Article
  12.Burroughs A, Sabin CA, Rolles K, Delvart V, Karam V, Buckels J et al (2006) 3-month and 12-month mortality after first liver transplant in adults in Europe: predictive models for outcome. Lancet 367:225-32PubMed View Article
  13.Roberts JP (2012) Impact of outcomes monitoring on innovation and risk in liver transplantation. Liver Transpl 18(Suppl 2):S59–S63PubMed View Article
  14.Abercassis MM, Burke R, Klintmalm GB, Matas AJ, Merion RM, Millman D, Olthoff K et al (2009) American Society of Transplant Surgeons transplant center outcomes requirements—a threat to innovation. Am J Transplant 9:1279-286View Article
  
• 作者单位：James Neuberger (1)
  
  1. Organ Donation and Transplantation, NHS Blood and Transplant, Fox Den Road, Bristol, BS34 8RR, UK
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  General Surgery
  Abdominal Surgery
  Cardiac Surgery
  Thoracic Surgery
  Traumatic Surgery
  Vascular Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1435-2451

文摘

Aim This review aims to outline the delivery of liver transplant services in the UK. Background Liver transplantation in the UK is based on seven designated transplant units serving a population of just over 60 million people. Nearly 900 liver transplants were done in 2013/2014. Process Potential deceased donors are identified and referred to centrally employed specialist nurses for obtaining family consent and for donor characterisation. Organs are retrieved by a National Organ Retrieval Service, based on seven abdominal and six cardiothoracic retrieval teams providing a 24/7 service which has shown to be capable of retrieving organs from up to ten donors a day. Donated organs are allocated first nationally to those who qualify for super-urgent listing. The next priority is for splitting livers, and if there is no suitable recipient or the liver is not suitable for splitting, then livers are offered first to the local centre; each centre has a designated donor zone, adjusted annually to ensure equity between the number of patients listed and the number of donors. The allocation scheme is being reviewed, and national schemes based on need, utility and benefit are being assessed. Governance Outcomes are monitored by National Health Service Blood and Transplant (NHSBT), and if there is a possibility of adverse deviation, then further inquiries are made. Outcomes, both from listing and from transplantation, are published by the centre on the NHSBT website (www.?odt.?nhs.?uk). NHSBT works closely with stakeholders primarily through the advisory groups with clinicians, patients, lay members and professional societies and aims to provide openness and transparency. Conclusions The system for organ donation and delivery of liver transplant in the UK has developed and is now providing an effective and efficient service, but there remains room for improvement.