Prélèvement d’organe en vue de la transplantation : évaluation de la charge de travail. A propos de 390 prélèvements

Introduction : An increase in the number of organ harvesting procedures remains an essential prerequisite to meet the growing demands of patients on transplantation waiting lists. Few publications have described the workload related to this surgical activity and the human resources, equipment and organization involved. In the context of a review by public authorities of the needs for transplantation teams, the authors propose a qualitative and quantitative study of this activity as well as its impact on the functioning of a urology department. Material and method : From January 1997 to December 2005, the Grenoble hospital urology department performed 390 organ harvesting procedures for a network of 5 hospitals located in three departments. Arrival and departure times, duration and the type of each procedure were recorded. The surgical team was composed of 5 surgeons until November 2003, with the arrival of a sixth surgeon. Results : During this period, 1,333 organs were harvested, including 775 kidneys. A typical organ harvesting procedure required the presence of the harvesting team from 8:15p.m. to 1:45 a.m. and lasted a mean of 5 hours. It was performed outside of the teaching hospital within the network in 29.7% of cases, after hours in 96.9% of cases and required a mandatory rest period on the following day in 60% of cases. Conclusion : Organ harvesting is an essential surgical procedure, but it is urgent, frequent, long, and interferes with organization of the urology department. In the age of redefinition of public health objectives in transplantation and application of mandatory rest periods, surgical teams need to be reinforced in order to maintain a constant level of elective urological surgery.