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Maastricht 分类 4 非心脏死亡供体肝移植的麻醉——病例报告

Anesthesia for liver transplantation from a maastricht category 4 non-heart-beating donor -A case report-.

机构信息

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2010 Dec;59 Suppl(Suppl):S119-23. doi: 10.4097/kjae.2010.59.S.S119. Epub 2010 Dec 31.

Abstract

Great improvements in patient selection, surgical techniques, perioperative care, and immunosuppression have been made for the optimization of liver transplantation. To increase the number of organs available for liver transplantation, transplant centers have used marginal donors, split livers, living donors, or non-heart-beating donors (NHBDs). Despite recent enthusiasm for NHBDs in liver transplantation, warm ischemic injury to recovered organs has been an obstacle for the wide acceptance of NHBD. In the present case, we have conducted a liver transplantation from a Maastricht Category 4 NHBD. Warm ischemic time was 20 minutes and cold ischemic time was 5 hour 43 minutes. Consequently, the liver was successfully transplanted into the recipient.

摘要

为了优化肝移植,在患者选择、手术技术、围手术期护理和免疫抑制等方面取得了重大进展。为了增加可用于肝移植的器官数量,移植中心已经使用边缘供体、劈裂肝脏、活体供体或心脏死亡供体(NHBD)。尽管 NHBD 在肝移植中最近受到广泛关注,但恢复器官的热缺血损伤一直是 NHBD 广泛接受的障碍。在本病例中,我们进行了一例来自马斯特里赫特 4 类 NHBD 的肝移植。热缺血时间为 20 分钟,冷缺血时间为 5 小时 43 分钟。结果,肝脏成功移植到受者体内。

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本文引用的文献

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The marginal liver donor--an update.边缘性肝脏供体——最新进展
Transpl Int. 2008 Aug;21(8):713-24. doi: 10.1111/j.1432-2277.2008.00696.x. Epub 2008 May 19.
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Transplantation from non-heart-beating donors.非心脏跳动供体移植
Transplant Proc. 2007 Apr;39(3):726-7. doi: 10.1016/j.transproceed.2007.01.071.
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Liver transplantation from non-heart beating donors.非心脏跳动供体肝脏移植
BMJ. 2006 Feb 18;332(7538):376-7. doi: 10.1136/bmj.332.7538.376.
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Report of a National Conference on Donation after cardiac death.心脏死亡后器官捐献全国会议报告
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