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体外循环在疑似脑死亡且伴有心肺功能衰竭的器官捐献者中的应用

The Use of Extracorporeal Circulation in Suspected Brain Dead Organ Donors with Cardiopulmonary Collapse.

作者信息

Lee Hyun, Cho Yang Hyun, Sung Kiick, Yang Jeong Hoon, Chung Chi Ryang, Jeon Kyeongman, Suh Gee Young

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2015 Dec;30(12):1911-4. doi: 10.3346/jkms.2015.30.12.1911. Epub 2015 Nov 30.

Abstract

Donor shortage is a major limitation in organ transplantation. Several studies have reported that extracorporeal membrane oxygenation (ECMO)-assisted organ donation can be successfully completed without inducing warm ischemia in patients with brain death. The present report described clinical experience of three patients (23-yr old man, 32-yr old man, and 41-yr old woman) who underwent ECMO for the evaluation of brain death and organ donation. They donated six kidneys, three livers, and one both lungs without warm ischemia by ECMO. Six kidney recipients successfully recovered normal status without hemodialysis and two liver recipients survived with normal liver functions, but one liver recipient and one lung recipient died 3 and 15 days after transplantation. Our report strongly encourages ECMO-assisted organ donation from brain death patients with refractory cardiopulmonary collapse to achieve improved organ transplantation.

摘要

供体短缺是器官移植的一个主要限制因素。多项研究报告称,体外膜肺氧合(ECMO)辅助器官捐献可在不引起脑死亡患者热缺血的情况下成功完成。本报告描述了三名患者(一名23岁男性、一名32岁男性和一名41岁女性)接受ECMO以评估脑死亡和器官捐献的临床经验。他们通过ECMO捐献了六个肾脏、三个肝脏和一对肺,未出现热缺血。六名肾移植受者成功恢复正常状态,无需进行血液透析,两名肝移植受者肝功能正常存活,但一名肝移植受者和一名肺移植受者分别在移植后3天和15天死亡。我们的报告强烈鼓励对患有难治性心肺衰竭的脑死亡患者进行ECMO辅助器官捐献,以改善器官移植情况。

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本文引用的文献

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Experience of heart transplantation from hemodynamically unstable brain-dead donors with extracorporeal support.
Clin Transplant. 2012 Sep-Oct;26(5):792-6. doi: 10.1111/j.1399-0012.2011.01585.x. Epub 2012 Jan 26.
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Extracorporeal membrane oxygenation support in potential organ donors for brain death determination.
Transplant Proc. 2011 Sep;43(7):2495-8. doi: 10.1016/j.transproceed.2011.06.027.

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