Purpose

We sought to collate and summarize existing literature on donor audits (DA) and how they have been used to guide deceased organ donation and transplantation system performance and quality assurance.

Source

We searched MEDLINE, Cumulative Index of Nursing and Allied Health Literature, and Web of Science supplemented by Google to identify grey literature on 6 May 2022, to locate studies in English, French, and Spanish. The data were screened, extracted, and analyzed independently by two reviewers. We grouped the results into five categories: 1) motivation for DA, 2) DA methodology, 3) potential and actual donors, 4) missed donation opportunities, and 5) quality improvement.

Principal findings

The search yielded 2,416 unique publications and 52 were included in this review. Most studies were from the UK (n = 13) and published between 2001 and 2006 (n = 15). The methodologies described for DA were diverse. Our findings showed that the primary motivation for conducting DA was to identify potential donors and the number of potential deceased organ donors is significantly higher than the number of actual donors. Among retrieved studies, the proportion of donation opportunities following neurologic determination of death was 95/222 (43%) compared with 25/181 (14%) for donation after cardiocirculatory death (DCD), suggesting that the missed donation rate is higher for DCD.

Conclusion

Donor audits help identify missed donation opportunities along the deceased donation pathway and can help support the evaluation of quality improvement initiatives.

中文翻译：

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死者器官捐赠的捐赠者审计：范围界定审查

目的

我们试图整理和总结有关捐赠者审核 (DA) 的现有文献，以及如何使用它们来指导死者器官捐赠和移植系统的绩效和质量保证。

来源

我们于 2022 年 5 月 6 日搜索了 MEDLINE、护理和联合健康文献累积索引以及由 Google 补充的 Web of Science，以识别灰色文献，以找到英语、法语和西班牙语的研究。数据由两名评审员独立筛选、提取和分析。我们将结果分为五类：1）DA 动机，2）DA 方法，3）潜在和实际捐赠者，4）错过捐赠机会，5）质量改进。

主要发现

检索产生了 2,416 种独特的出版物，其中 52 种被纳入本次综述中。大多数研究来自英国 ( n  = 13)，发表于 2001 年至 2006 年间 ( n  = 15)。DA 描述的方法多种多样。我们的研究结果表明，进行DA的主要动机是确定潜在的捐赠者，潜在的已故器官捐赠者的数量明显高于实际捐赠者的数量。在检索到的研究中，神经系统确定死亡后的捐献机会比例为 95/222（43%），而心循环死亡（DCD）后的捐献机会比例为 25/181（14%），表明 DCD 的错过捐献率更高。

结论

捐赠者审核有助于识别死者捐赠途径中错过的捐赠机会，并有助于支持质量改进举措的评估。