論文種別	原著(症例報告除く)
言語種別	英語
査読の有無	その他(不明)
表題	Institutional Variability in Brain-Dead Organ Donation Processes and Practices: A Multicenter Cohort Study.
掲載誌名	正式名：Critical care medicine 略　 称：Crit Care Med ISSNコード：15300293/00903493
掲載区分	国外
巻・号・頁	pp.Online ahead of print
著者・共著者	Tetsuya Yumoto, Hiromichi Naito, Mineji Hayakawa, Shoji Yokobori, Kei Nishiyama, Takahiro Atsumi, Osamu Tasaki, Junya Tsurukiri, Mariko Hayamizu, Shimon Murahashi, Munehiro Hayashi, Takeshi Nishimura, Yukari Goto, Hiromichi Narumiya, Atsushi Mizutani, Mamoru Miyajima, Junya Shimazaki, Takeshi Miura, Nozomu Shima, Kazuki Deuchi, Hitomi Nakayasu, Hitoshi Kano, Takashi Yorifuji, Atsunori Nakao,
発行年月	2026/03
概要	OBJECTIVES:To determine whether key institutional and clinical differences exist between highly and moderately active hospitals in Japan with respect to brain-dead organ donation practices.DESIGN:Retrospective multicenter cohort study.SETTING:Sixteen tertiary emergency and critical care centers across Japan.PATIENTS:All brain-dead organ donors from participating institutions who had at least one organ procured and transplanted between July 17, 2010, and December 31, 2023. Hospitals were categorized as highly active (≥ 14 donations) or moderately active (≤ 13 donations) during the study period.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Institutional donation practices were compared, including donor management strategies, use of vasopressors and corticosteroids, time intervals in the donation process, and frequency of multidisciplinary team meetings. A total of 204 donors were included; the median age was 47 years (interquartile range, 37-56), and 92 (45.1%) were female. Donor characteristics were similar between groups. Vasopressin was used in nearly all donors, though dosing protocols varied. Corticosteroid use was significantly higher in highly active hospitals compared with moderately active ones (58.3% vs. 38.0%; p = 0.004). Time from admission to coordinator notification was similar; however, time to family consent (median, 8 vs. 5 d; p < 0.001) and time to organ procurement (median, 12 vs. 9 d; p = 0.006) were longer in highly active hospitals. These hospitals also conducted more multidisciplinary meetings during donor management (median, 2 vs. 0; p < 0.001).CONCLUSIONS:Highly active hospitals demonstrated more intensive donor management practices, longer timeframes for key donation steps, and greater multidisciplinary engagement. Standardization of donation practices may enhance efficiency and support broader dissemination of effective institutional strategies to improve brain-dead organ donation rates in Japan.
DOI	10.1097/CCM.0000000000007120
PMID	41885543