Department of Pharmacology and Anesthesiology, University of Padua, Padua, Italy.
Minerva Anestesiol. 2010 Jul;76(7):525-33.
Living donor transplantation has helped to partially relieve the refractory shortage of deceased donor grafts. However, living related donation exposes healthy donors to a certain risk of morbidity and even mortality. Anesthetic management of elective live donation surgery with a relatively young and healthy patient is apparently simple; nonetheless, it requires both knowledge and diligence from the anesthesiologist. Some concerns persist regarding the appropriate intraoperative organ protection strategy and potential negative effects of certain surgical maneuvers on graft function. Even when careful attention is paid to maintaining intraoperative cardiorespiratory and metabolic homeostasis, preventing blood loss, preserving renal function, and assuring adequate postoperative analgesia, among other things, these procedures are not completely devoid of some major risks related to anesthesia and surgery. Maximal effort should be applied to minimize the perioperative risks for the donor, every minimal impending complication should be promptly recognized, and a timely treatment implemented. Some anesthetic considerations regarding the most frequently performed living organ transplantations are briefly reported in this article.
活体供者移植有助于部分缓解供体器官短缺的问题。然而，活体相关捐赠使健康供者面临一定的发病甚至死亡风险。对于相对年轻和健康的择期活体捐献手术，麻醉管理显然很简单；但这需要麻醉医生具备相关知识和勤勉。对于术中器官保护策略以及某些手术操作对移植物功能的潜在负面影响，仍存在一些担忧。即使术中仔细注意维持心肺和代谢的内环境稳定、预防失血、保护肾功能和确保足够的术后镇痛等，这些操作仍不能完全避免与麻醉和手术相关的一些重大风险。应该尽最大努力使供者的围手术期风险最小化，及时识别每一个即将出现的并发症，并及时进行治疗。本文简要介绍了最常进行的活体器官移植的一些麻醉考虑。
