来自在体外膜肺氧合支持下的非控制性非心脏跳动供体的肝移植。
Liver transplantation from an uncontrolled non-heart-beating donor maintained on extracorporeal membrane oxygenation.
作者信息
Wang C-C, Wang S-H, Lin C-C, Liu Y-W, Yong C-C, Yang C-H, Huang K-C, Lin T-S, Jawan B, Cheng Y-F, Eng H-L, Concejero A M, Chen C-L
机构信息
Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan.
出版信息
Transplant Proc. 2005 Dec;37(10):4331-3. doi: 10.1016/j.transproceed.2005.11.013.
Liver transplantation, a definitive treatment for end-stage liver disease, has achieved excellent results. However, potential recipients on the waiting list outnumber donors. To expand the donor pool, marginal grafts from older donors, steatotic livers, and non-heart-beating liver donors (NHBD) have been used for transplantation. Reducing the warm ischemia time of NHBD is the critical factor in organs preservation. Liver transplantation using grafts from NHBD have been reported to display a high incidence of primary graft nonfunction and biliary complications. The authors report a liver graft donor who was maintained on extracorporeal membrane oxygenation (ECMO) after successful cardiopulmonary resuscitation. Core body temperature was 5 degrees C. Procurement of the liver using a rapid flush technique was performed 4 hours after instituting ECMO. Graft function recovered fully after transplantation. In conclusion, ECMO may be used to reduce warm ischemia time in liver grafts obtained from uncontrolled NHBD, thereby increasing graft salvage rates.
肝移植作为终末期肝病的一种确定性治疗方法，已取得了优异的效果。然而，等待名单上的潜在受者数量超过了供者。为了扩大供者库，已将来自老年供者的边缘性移植物、脂肪变性肝脏和非心脏跳动供肝（NHBD）用于移植。缩短NHBD的热缺血时间是器官保存的关键因素。据报道，使用NHBD移植物进行肝移植时，原发性移植物无功能和胆道并发症的发生率很高。作者报告了一例在成功进行心肺复苏后接受体外膜肺氧合（ECMO）支持的肝脏供者。核心体温为5摄氏度。在启动ECMO 4小时后，采用快速冲洗技术获取肝脏。移植后移植物功能完全恢复。总之，ECMO可用于缩短从非控制性NHBD获取的肝移植物的热缺血时间，从而提高移植物挽救率。
Zotero 插件