Matsumoto Hiroshi, Kaku Keizo, Kubo Shinsuke, Hisadome Yu, Noguchi Hiroshi, Okabe Yasuhiro, Morisaki Koichi, Takahashi Keita, Momii Kenta, Kaku Noriyuki, Akahoshi Tomohiko, Nakamura Masafumi
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan.
Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.24-0174. Epub 2025 May 27.
The shortage of organ donors is a major challenge in transplantation. Expanding donor eligibility criteria can help increase the donor pool, but it is crucial to carefully assess the risks related to infections in donors with expanded criteria. Organ donation from trauma patients who have undergone open abdominal management (OAM) is uncommon because of concerns regarding organ damage and infection risk. However, with appropriate OAM and stringent infection control, safe organ donation may be possible.
We herein present a case involving a patient who sustained abdominal organ injuries and head trauma from a fall. Emergency laparotomy was performed, including splenectomy for a splenic injury and liver laceration repair, followed by OAM using ABTHERA (3M Health Care, St. Paul, MN, USA). The patient subsequently developed irreversible brain damage and was declared brain dead. The patient's family consented to organ donation. Following thorough evaluation, the heart, lungs, and liver were successfully recovered and transplanted into recipients at three different institutions, with no severe infections or rejection episodes reported.
This case illustrates that with proper management using ABTHERA in OAM, organ donation can be safely achieved even in challenging cases involving trauma patients.
器官捐献者短缺是移植领域的一项重大挑战。扩大捐献者资格标准有助于增加供体库，但仔细评估符合扩大标准的捐献者的感染相关风险至关重要。由于担心器官损伤和感染风险，接受过腹部开放处理（OAM）的创伤患者进行器官捐献的情况并不常见。然而，通过适当的OAM和严格的感染控制，安全的器官捐献或许是可行的。
我们在此报告一例病例，患者因跌倒导致腹部器官损伤和头部创伤。进行了急诊剖腹手术，包括因脾损伤行脾切除术和肝裂伤修复术，随后使用ABTHERA（美国明尼苏达州圣保罗市3M医疗保健公司）进行OAM。患者随后出现不可逆性脑损伤并被宣布脑死亡。患者家属同意器官捐献。经过全面评估，心脏、肺和肝脏成功获取并移植到三个不同机构的受者体内，未报告严重感染或排斥反应。
本病例表明，在OAM中使用ABTHERA进行适当管理，即使在涉及创伤患者的具有挑战性的病例中，也能安全实现器官捐献。
