Anwar A S M Tanim, Lee Jae-Myeong
Department of Nephrology, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Department of Acute Care Surgery, Korea University Anam Hospital, Seoul, Korea.
Acute Crit Care. 2019 Feb;34(1):14-29. doi: 10.4266/acc.2019.00430. Epub 2019 Feb 28.
With improving healthcare services, the demand for organ transplants has been increasing daily worldwide. Deceased organ donors serve as a good alternative option to meet this demand. The first step in this process is identifying potential organ donors. Specifically, brain-dead patients require aggressive and intensive care from the declaration of brain death until organ retrieval. Currently, there are no specific protocols in place for this, and there are notable variations in the management strategies implemented across different transplant centers. Some transplant centers follow their own treatment protocols, whereas other countries, such as Bangladesh, do not have any protocols for potential organ donor care. In this review, we discuss how to identify brain-dead donors and describe the physiological changes that occur following brain death. We then summarize the management of brain-dead organ donors and, on the basis of a review of the literature, we propose recommendations for a treatment protocol to be developed in the future.
随着医疗服务的改善，全球范围内对器官移植的需求与日俱增。已故器官捐赠者是满足这一需求的良好替代选择。这一过程的第一步是识别潜在的器官捐赠者。具体而言，脑死亡患者从脑死亡宣告到器官获取期间需要积极且强化的护理。目前，对此尚无具体的方案，不同移植中心实施的管理策略存在显著差异。一些移植中心遵循自身的治疗方案，而其他国家，如孟加拉国，对于潜在器官捐赠者的护理没有任何方案。在本综述中，我们讨论如何识别脑死亡捐赠者，并描述脑死亡后发生的生理变化。然后我们总结脑死亡器官捐赠者的管理，并在文献综述的基础上，对未来制定的治疗方案提出建议。
