Brockmann J G, Vaidya A, Reddy S, Friend P J
Nuffield Department of Surgery, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK.
Br J Surg. 2006 Feb;93(2):133-46. doi: 10.1002/bjs.5228.
Organ retrieval and donor management are not yet standardized. Different transplant centres apply various techniques, such as single or dual organ perfusion, dissection in the cold or warm, and single or en bloc organ removal. These different approaches may cause inconvenience, especially when more than one organ retrieval team is involved.
Cochrane Library, Medline and PubMed were searched for publications on multiorgan donor/donation, retrieval technique and procurement. Levels of evidence and grades of recommendation were evaluated based on current advice from the Oxford Centre for Evidence-Based Medicine.
Multiorgan donation itself does not compromise the outcome of individual organ transplants. Dissection of abdominal organs for transplantation is best performed after cold perfusion. Abdominal organs should be removed rapidly, en bloc, and separated during back-table dissection in the cold, particularly if pancreas or intestine is included. Perfusion itself should be carried out after single cannulation of the aorta with an increased pressure.
Although the literature on organ retrieval is extensive, the level of evidence provided is mainly low. Nevertheless, optimized donor treatment and organ retrieval should increase the number and quality of cadaveric donor organs and improve graft function and survival.
器官获取与供体管理尚未标准化。不同的移植中心采用各种技术，如单器官或双器官灌注、冷或热状态下的解剖以及单器官或整块器官切除。这些不同的方法可能会带来不便，尤其是当涉及多个器官获取团队时。
检索Cochrane图书馆、Medline和PubMed，查找关于多器官供体/捐赠、获取技术和器官切取的出版物。根据牛津循证医学中心的当前建议评估证据水平和推荐等级。
多器官捐赠本身不会影响单个器官移植的结果。腹部器官用于移植的解剖最好在冷灌注后进行。腹部器官应迅速整块切除，并在冷状态下的后台解剖过程中分离，特别是如果包含胰腺或肠道。灌注本身应在通过增加压力对主动脉进行单插管后进行。
尽管关于器官获取的文献很多，但所提供的证据水平主要较低。然而，优化供体治疗和器官获取应能增加尸体供体器官的数量和质量，并改善移植物功能和存活率。
