Analysis of causes of death and etiological characteristics of skin tissue donors
-
摘要: 目的 调查皮肤组织无偿捐献供者的死亡原因及病原学特征,为异体皮移植提供参考。 方法 2008年10月—2018年10月,武汉市第三医院烧伤科接收的49例无偿捐献皮肤组织的供者符合本研究入选标准,对其进行横断面研究。根据死亡原因,将供者分为意外死亡组19例和非意外死亡组30例。统计49例供者性别、死亡年龄,对比不同性别供者死亡年龄、意外死亡组与非意外死亡组供者死亡年龄;统计引起供者死亡的疾病或情况;统计49例供者乙肝、丙肝、获得性免疫缺陷综合征、梅毒病毒携带情况及外周血微生物培养结果,对比意外死亡组与非意外死亡组供者血源性传染危险因素检出情况。另选取异体皮制备过程中的异常皮肤组织进行病理学检查。对数据行Mann-Whitney
U 检验、连续性校正χ 2检验。 结果 (1)本组49例供者中,男38例(77.55%)、女11例(22.45%)。死亡年龄为42.00(24.00,55.00)岁,男性供者死亡年龄与女性供者相近(Z =0.120,P >0.05);意外死亡组供者死亡年龄低于非意外死亡组,但差异无统计学意义(Z =-1.581,P >0.05)。(2)引起本组49例供者死亡的疾病和情况中,损伤、中毒以及外因的某些其他后果19例(38.78%),循环系统疾病11例(22.45%),肿瘤9例(18.37%),神经系统疾病3例(6.12%),呼吸系统疾病2例(4.08%),先天性畸形、变形和染色体异常2例(4.08%),血液及造血器官疾病和涉及免疫机制的某些疾患1例(2.04%),消化系统疾病1例(2.04%),泌尿生殖系统疾病1例(2.04%)。(3)本组49例供者中共9例(18.37%)存在血源性传染危险因素,其中血源性传染病8例(16.33%),分别为乙肝5例(10.20%)、梅毒2例(4.08%)、丙肝1例(2.04%);血微生物培养阳性1例(2.04%),检出多药耐药铜绿假单胞菌。意外死亡组2例供者检出血源性传染危险因素,检出比例低于非意外死亡组(7例),但差异无统计学意义(χ 2=0.562,P >0.05)。(4)本组共选出8例供者异常皮肤组织,其中皮内色素痣4例、瘢痕1例、假上皮瘤样增生1例、表皮疣状增生1例、真皮层见大量色素颗粒1例。 结论 皮肤组织无偿捐献供者以疾病导致的非意外死亡为主,非意外死亡供者来源性感染风险较意外死亡供者稍高。异体皮获取和移植前应仔细调查供者死亡原因,评估健康状况,避免供者来源性感染的发生。Abstract: Objective To investigate the causes of death and etiological characteristics of skin tissue donors, and to provide reference for allogeneic skin transplantation. Methods From October 2008 to October 2018, 49 skin tissue donors accepted by the Burn Department of Wuhan Third Hospital met the inclusion criteria of this study, and a cross-sectional study was conducted. According to the cause of death, the donors were divided into accidental death group (19 cases) and non-accidental death group (30 cases). The sex and death age of 49 donors were recorded, and the death age between different sex donors and that of donors between accidental death group and non-accidental death group were compared. Diseases or circumstances that caused the death of donors, hepatitis B, hepatitis C, acquired immunodeficiency syndrome, syphilis virus carrying status, and peripheral blood microbial culture results of 49 donors were recorded, and the detection of blood-borne infectious risk factors of donors between accidental death group and non-accidental death group was compared. Abnormal skin tissue was also selected during allogenic skin graft preparing for pathological examination. Data were statistically analyzed with Mann-WhitneyU test and continuity correction chi-square test. Results (1) Out of the 49 donors in this group, 38 were male (77.55%) and 11 were female (22.45%). The death age was 42.00 (24.00, 55.00) years, and the death age of male donors was similar to that of female donors (Z =0.120,P >0.05). The death age of donors in accidental death group was lower than that in non-accidental death group, but the difference was not statistically significant (Z =-1.581,P >0.05). (2) Among the causes and circumstances of the 49 donors in this group, there were 19 cases (38.78%) of injury, poisoning, and some other consequences of external causes, 11 cases (22.45%) of circulatory system diseases, 9 cases (18.37%) of tumors, 3 cases (6.12%) of nervous system diseases, 2 cases (4.08%) of respiratory system diseases, and 2 cases (4.08%) of congenital malformation, deformation, and chromosome abnormality, 1 case (2.04%) of blood and hematopoietic organ diseases and some diseases related to immune mechanism, 1 case (2.04%) of digestive system disease, and 1 case (2.04%) of genitourinary system disease. (3) There were 9 donors (18.37%) with blood-borne infectious risk factors among the 49 donors in this group, including 8 cases (16.33%) of blood-borne infectious diseases, which were 5 cases (10.20%) of hepatitis B, 2 cases (4.08%) of syphilis, and 1 case (2.04%) of hepatitis C, respectively. Blood microorganism culture was positive in 1 case (2.04%), in which multi-drug resistantPseudomonas aeruginosa was detected. Risk factors of blood-borne infection were detected in 2 donors in accidental death group, with detection ratio lower than that in non-accidental death group (7 cases), but the difference was not statistically significant (χ 2=0.562,P >0.05). (4) A total of 8 donors′ abnormal skin tissue were selected, including 4 cases of intradermal pigmented nevus, 1 case of scar, 1 case of pseudoepithelioma hyperplasia, 1 case of epidermal verrucous hyperplasia, and 1 case of large amount of pigment granules in dermis. Conclusions Non-accidental death caused by diseases is the main cause of death of skin tissue donors, and the risk of donor-derived infection of non-accidentally dead donors is slightly higher than that of accidentally dead donors. Before the allogeneic skin is obtained and transplanted, the cause of death of the donor should be carefully investigated, and the health status should be evaluated, so as to avoid the occurrence of donor-derived infection. -
点击查看大图
计量
- 文章访问数: 35
- HTML全文浏览量: 0
- PDF下载量: 6
- 被引次数: 0