Circelli Alessandro, Brogi Etrusca, Gamberini Emiliano, Russo Emanuele, Benni Marco, Scognamiglio Giovanni, Nanni Andrea, Coccolini Federico, Forfori Francesco, Fugazzola Paola, Ansaloni Luca, Solli Piergiorgio, Benedetto Fabrizio Di, Cescon Matteo, Agnoletti Vanni
Department of Intensive Care Anesthesia and Trauma Division, Cesena, Italy.
Department of Anesthesia and Intensive Care, University of Pisa, Pisa, Italy.
J Int Med Res. 2021 Mar;49(3):3000605211000519. doi: 10.1177/03000605211000519.
Even with encouraging recipient outcomes, transplantation using donation after circulatory death (DCD) is still limited. A major barrier to this type of transplantation is the consequences of warm ischemia on graft survival; however, preservation techniques may reduce the consequences of cardiac arrest and provide better organ conservation. Furthermore, DCD in trauma patients could further expand organ donation. We present five cases in which organs were retrieved and transplanted successfully using normothermic regional perfusion (NRP) in trauma patients. Prompt critical care support and surgical treatment allowed us to overcome the acute phase. Unfortunately, owing to the severity of their injuries, all of the donors died. However, the advanced and continuous organ-specific supportive treatment allowed the maintenance of general clinical stability and organ preservation. Consequently, it was possible to retrieve and transplant the donors' organs. Death was ascertained in accordance with cardio-circulatory criteria, which was followed by NRP. We consider that DCD in trauma patients may represent an important source of organs.
即便受体预后令人鼓舞，但使用循环死亡后捐赠（DCD）进行的移植仍受到限制。此类移植的一个主要障碍是热缺血对移植物存活的影响；然而，保存技术可能会减轻心脏骤停的后果并实现更好的器官保存。此外，创伤患者的DCD可能会进一步扩大器官捐赠。我们呈现了5例在创伤患者中使用常温区域灌注（NRP）成功获取并移植器官的病例。及时的重症监护支持和手术治疗使我们能够度过急性期。不幸的是，由于伤势严重所有捐赠者均死亡。然而，先进且持续的器官特异性支持治疗维持了一般临床稳定性并实现了器官保存。因此，成功获取并移植了捐赠者的器官。根据心肺循环标准判定死亡，随后进行NRP。我们认为创伤患者的DCD可能是一个重要的器官来源。
