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器官捐献:我们何时应考虑捐献肠道。

Organ donation: when should we consider intestinal donation.

机构信息

Region Baden-Württemberg, Deutsche Stiftung Organtransplantation, Stuttgart, Germany.

出版信息

Transpl Int. 2012 Dec;25(12):1229-40. doi: 10.1111/j.1432-2277.2012.01556.x. Epub 2012 Sep 21.

Abstract

UNLABELLED

Although more than 2300 intestinal transplantations (IT) have been performed worldwide, a description of intestinal donor criteria is still missing. This causes confusion among transplant coordinators, OPOs, physicians at intensive care unit and transplant surgeons. A Med-line search looking for publications about donor criteria or donor selection in human IT was performed in December 2011. Retrospective analysis of 39 deceased donors from whom, in the period January 2006-December 2011, 20 isolated intestinal grafts and 19 multivisceral grafts were recovered and successfully transplanted.

REVIEW OF THE LITERATURE

Among 3504 publications about IT, no study reported specifically about intestinal donor profile. The most commonly cited donor criterion was age, while all other criteria were inconsistently discussed. Based on the collected data, we suggest following inclusion criteria for donation of IT grafts: age 0-50 years, ICU-stay <1 week, no blunt abdominal trauma, most recent Sodium <155 mmol/l, no severe ongoing transfusion requirements, standard donor therapy including early enteral nutrition and a compatible donor-recipient size match. By providing simple criteria for intestinal donation from deceased donor, we may help to properly utilize the limited donor pool.

摘要

目的

尽管全世界已经进行了超过 2300 例肠移植(IT),但仍缺乏对肠供体标准的描述。这导致移植协调员、OPO、重症监护病房的医生和移植外科医生感到困惑。2011 年 12 月进行了 Medline 搜索,以查找关于人类 IT 中供体标准或供体选择的出版物。对 2006 年 1 月至 2011 年 12 月期间的 39 名已故供体进行回顾性分析,从这些供体中回收并成功移植了 20 例孤立的肠移植和 19 例多器官移植。

文献复习

在关于 IT 的 3504 篇出版物中,没有一项研究专门报告肠道供体特征。最常引用的供体标准是年龄,而其他所有标准的讨论都不一致。根据收集的数据,我们建议以下 IT 移植物捐赠的纳入标准:年龄 0-50 岁,入住 ICU<1 周,无钝性腹部创伤,最近的钠<155mmol/L,无严重持续输血需求,标准供体治疗包括早期肠内营养和供体与受体的相容尺寸匹配。通过为来自已故供体的肠捐赠提供简单的标准,我们可以帮助更好地利用有限的供体池。

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