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体外膜肺氧合患者的器官捐献:系统评价。

Organ Donation from Patients Receiving Extracorporeal Membrane Oxygenation: A Systematic Review.

机构信息

Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria.

Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria.

出版信息

J Cardiothorac Vasc Anesth. 2024 Jul;38(7):1531-1538. doi: 10.1053/j.jvca.2024.03.020. Epub 2024 Mar 20.

Abstract

OBJECTIVE

The mismatch between the demand for and supply of organs for transplantation is steadily growing. Various strategies have been incorporated to improve the availability of organs, including organ use from patients receiving extracorporeal membrane oxygenation (ECMO) at the time of death. However, there is no systematic evidence of the outcome of grafts from these donors.

DESIGN

Systematic literature review (Scopus and PubMed, up to October 11, 2023).

SETTING

All study designs.

PARTICIPANTS

Organ recipients from patients on ECMO at the time of death.

INTERVENTION

Outcome of organ donation from ECMO donors.

MEASUREMENTS AND MAIN RESULTS

The search yielded 1,692 publications, with 20 studies ultimately included, comprising 147 donors and 360 organ donations. The most frequently donated organs were kidneys (68%, 244/360), followed by liver (24%, 85/360). In total, 98% (292/299) of recipients survived with a preserved graft function (92%, 319/347) until follow-up within a variable period of up to 3 years.

CONCLUSION

Organ transplantation from donors supported with ECMO at the time of death shows high graft and recipient survival. ECMO could be a suitable approach for expanding the donor pool, helping to alleviate the worldwide organ shortage.

摘要

目的

器官移植的供需差距一直在稳步扩大。为了增加器官的供应量,已经采用了各种策略,包括在患者死亡时使用体外膜肺氧合(ECMO)的器官。然而,这些供体器官的移植效果尚无系统证据。

设计

系统文献回顾(Scopus 和 PubMed,截至 2023 年 10 月 11 日)。

设置

所有研究设计。

参与者

在死亡时接受 ECMO 的患者的器官接受者。

干预措施

ECMO 供体的器官捐献结果。

测量和主要结果

搜索结果产生了 1692 篇出版物,最终包括 20 项研究,共涉及 147 名供体和 360 次器官捐献。最常捐献的器官是肾脏(68%,244/360),其次是肝脏(24%,85/360)。在总共 299 名接受者中,有 98%(292/299)的受者在移植后存活,且移植物功能正常(92%,319/347),随访时间在 3 年以内不等。

结论

在死亡时接受 ECMO 支持的供体进行器官移植可获得较高的移植物和受者存活率。ECMO 可能是扩大供体库的一种合适方法,有助于缓解全球器官短缺问题。

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