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评估和利用有机磷农药中毒供者器官。

Evaluation and Use of Organs from Donors Poisoned by Organophosphorus Pesticide.

机构信息

Transplant Medical Center of the Second Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China (mainland).

Transplant Medical Center of the Second Affiliated Hospital, Guangxi Medical University, Nanning, China (mainland).

出版信息

Ann Transplant. 2023 Mar 31;28:e939343. doi: 10.12659/AOT.939343.

DOI:10.12659/AOT.939343
PMID:37043447
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10071879/
Abstract

BACKGROUND The aim of this study was to explore the evaluation and use of donor organs from donors with brain death caused by acute severe organophosphorus pesticides and provide a basis for the use of such donor organs. MATERIAL AND METHODS Seven cases of brain dead donors caused by acute organophosphorus pesticide poisoning from January 2014 to December 2018 in the hospital were collected, and a retrospective analysis was made of the donors' age, race, physiological and pathological changes, donor organ function changes and the organ use, liver or kidney function recovery, and complications of the recipients. The 18 recipients were followed up until June 31, 2022. RESULTS We found that 71.42% of organ donors were male, and 71.42% of organ donors were under 50 years old. The main cause of death was respiratory failure caused by organophosphorus pesticide poisoning. The liver and kidney functions of 7 donors were damaged, and 3 livers could not be used due to severe functional damage, but the liver or kidney function of 18 recipients gradually recovered after transplantation. Delayed recovery of graft function occurred after transplantation accounted for 21.43%, and the grafts had good short-term to medium-term performance. CONCLUSIONS Although the function of organs from donor with brain death due to acute severe organophosphorus pesticide poisoning is seriously damaged, most of the organs can still be used for transplantation. Individualized functional maintenance according to the situation of donors is conducive to improving the quality of organs.

摘要

背景

本研究旨在探讨急性重度有机磷农药中毒脑死亡供者器官的评估和利用,为此类供者器官的利用提供依据。

材料与方法

收集我院 2014 年 1 月至 2018 年 12 月因急性有机磷农药中毒致脑死亡的 7 例供者临床资料,回顾性分析供者年龄、种族、病理生理变化、供者器官功能变化及器官利用情况、肝肾功能恢复情况及受者并发症。18 例受者随访至 2022 年 6 月 31 日。

结果

发现 71.42%的器官供者为男性,71.42%的器官供者年龄<50 岁。主要死亡原因为有机磷中毒致呼吸衰竭。7 例供者存在肝肾功能损伤,3 例因肝功能严重损伤未能利用肝脏,18 例受者移植术后肝肾功能逐渐恢复。移植术后出现移植肾功能延迟恢复者占 21.43%,移植物短期至中期性能良好。

结论

虽然急性重度有机磷农药中毒脑死亡供者器官功能严重受损,但大部分器官仍可用于移植。根据供者情况进行个体化功能维护有利于提高器官质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/d9088d237f07/anntransplant-28-e939343-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/25e992c97c17/anntransplant-28-e939343-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/e3fb59791764/anntransplant-28-e939343-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/2e24d2c2b8fb/anntransplant-28-e939343-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/d9088d237f07/anntransplant-28-e939343-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/25e992c97c17/anntransplant-28-e939343-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/e3fb59791764/anntransplant-28-e939343-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/2e24d2c2b8fb/anntransplant-28-e939343-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644f/10071879/d9088d237f07/anntransplant-28-e939343-g004.jpg

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本文引用的文献

1
Management of Organophosphorus Poisoning: Standard Treatment and Beyond.有机磷中毒的处理:标准治疗及其他。
Crit Care Clin. 2021 Jul;37(3):673-686. doi: 10.1016/j.ccc.2021.03.011.
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Evaluation and application of donors with primary central nervous system tumors.原发性中枢神经系统肿瘤供者的评估与应用。
Clin Transplant. 2019 Oct;33(10):e13677. doi: 10.1111/ctr.13677. Epub 2019 Oct 23.
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Impact of acute kidney injury on distant organ function: recent findings and potential therapeutic targets.急性肾损伤对远隔器官功能的影响:最新发现及潜在治疗靶点
Kidney Int. 2016 Mar;89(3):555-64. doi: 10.1016/j.kint.2015.11.019. Epub 2016 Jan 16.
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2014 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 32nd Annual Report.美国中毒控制中心协会国家中毒数据系统(NPDS)2014年年报:第32次年度报告。
Clin Toxicol (Phila). 2015;53(10):962-1147. doi: 10.3109/15563650.2015.1102927.
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The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis.延迟移植肾功能对肾移植中移植物和患者生存的影响:一种使用竞争事件分析的方法。
Transpl Int. 2015 Jun;28(6):738-50. doi: 10.1111/tri.12543. Epub 2015 Feb 26.
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Kidneys from donors after cardiac death provide survival benefit.心脏死亡供体的肾脏可带来生存获益。
J Am Soc Nephrol. 2010 Jun;21(6):1015-21. doi: 10.1681/ASN.2009121203. Epub 2010 May 20.
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Experience in renal and extrarenal transplantation with donation after cardiac death donors with selective use of extracorporeal support.心脏死亡后供体选择性使用体外支持进行肾移植和肾外器官移植的经验。
J Am Coll Surg. 2008 May;206(5):1028-37; discussion 1037. doi: 10.1016/j.jamcollsurg.2007.12.029. Epub 2008 Mar 17.