From the Anesthesiology and ICM Department, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2021 May;19(5):497-500. doi: 10.6002/ect.2019.0152. Epub 2020 Aug 7.
Organ transplant from donors with ventricular assist devices is not common. Here, we report organ retrieval from a donor with a left ventricular assist device who had been on the heart transplant wait list before a brain death diagnosis. The organ donor was diagnosed with dilated cardiomyopathy and underwent left ventricular assist device surgery for bridging to heart transplant in 2016. Brain death occurred 22 months after implantation of the device at the age of 39 years due to widespread intraparenchymal and subarachnoid hemorrhage. Brain death diagnosis was confirmed with brain perfusion single-photon emission computed tomography. In accordance with the donor's will, the relatives approved organ donation. The donor's organ reserve was assessed to be suitable for liver and kidney transplants, and proper donor care was given. During recovery of organs, the organ transplant team was accompanied by cardiovascular surgeons to control flow of the left ventricular assist device and to ensure optimum organ perfusion. After a successful operation, the liver was transplanted to a patient with primary sclerosing cholangitis who had been on the wait list for liver transplant for 13 years. The kidneys were transplanted to patients awaiting kidney transplant for 31 and 14 years with diagnoses of nephrolithiasis and polycystic kidney disease, respectively. No complications occurred among the liver and kidney transplant recipients. There are few reports of donors with assist devices. This is the first case of an organ donor with an assist device waiting for an organ transplant who became an actual donor in our country.
从带有心室辅助装置的供体中进行器官移植并不常见。在这里，我们报告了一例从一位带有左心室辅助装置的供体中获取器官的病例，该供体在被诊断为脑死亡之前一直在心脏移植等待名单上。该器官捐献者被诊断为扩张型心肌病，并于 2016 年因左心室辅助装置手术进行桥接以进行心脏移植。该患者在植入装置后 22 个月因广泛的脑实质内和蛛网膜下腔出血而脑死亡，脑死亡诊断得到了脑灌注单光子发射计算机断层扫描的证实。根据供体的意愿，亲属批准了器官捐献。评估供体的器官储备适合进行肝和肾移植，并给予适当的供体护理。在恢复器官期间，器官移植团队由心血管外科医生陪同，以控制左心室辅助装置的流量，并确保最佳的器官灌注。手术成功后，肝脏被移植给一名患有原发性硬化性胆管炎的患者，该患者已在等待肝移植名单上 13 年。肾脏被移植给分别患有肾结石和多囊肾病、等待肾移植 31 年和 14 年的患者。肝和肾移植受者均未发生并发症。带有辅助设备的供体报告很少。这是我国首例等待器官移植的带有辅助装置的供体成为实际供体的病例。
