Roberts J R, Bain M, Klachko M N, Seigel E G, Wason S
Department of Emergency Medicine, Mercy Catholic Medical Center, Philadelphia, Pennsylvania, USA.
Ann Emerg Med. 1995 Nov;26(5):652-5. doi: 10.1016/s0196-0644(95)70021-8.
Heart transplantation has become a highly successful, life-saving treatment for a number of otherwise fatal heart diseases. A major limiting factor in the growth of transplantation surgery has been the relative lack of suitable donor organs, and the appropriate criteria for selection of donor organs have been a topic of significant interest. Despite relatively favorable survival rates in the few patients who have received organs from victims of many types of poisonings and drug overdoses, patients dying of toxicologic causes are not usually considered suitable organ donors. Some centers routinely reject such individuals. Criteria for donor selection continue to be vague, unclear, or nonexistent in regard to organ transplantation from victims of all types of poisoning and toxic exposures. Carbon monoxide (CO) is a ubiquitous poison, and although victims of CO poisoning have occasionally served as suitable organ donors, heart transplantation in this scenario is still a very rare event. We describe the successful transplantation of the heart from a CO poisoning victim--to our knowledge, only the third such transplantation. Because the emergency department is a critical site for organ procurement, emergency physicians must be aware that patients dying of CO exposure may be acceptable organ donors.
心脏移植已成为治疗多种原本致命性心脏病的一种极为成功的挽救生命的疗法。移植手术发展的一个主要限制因素是相对缺乏合适的供体器官，而选择供体器官的适当标准一直是人们极为关注的话题。尽管少数接受了多种中毒和药物过量受害者器官的患者存活率相对较高，但死于毒理学原因的患者通常不被视为合适的器官供体。一些中心通常会拒绝这类个体。关于从各类中毒和有毒暴露受害者身上获取器官进行移植的供体选择标准仍然模糊、不明确或根本不存在。一氧化碳（CO）是一种普遍存在的毒物，虽然一氧化碳中毒的受害者偶尔会成为合适的器官供体，但在这种情况下进行心脏移植仍然是非常罕见的事件。我们描述了一例成功将一名一氧化碳中毒受害者的心脏进行移植的案例——据我们所知，这是此类移植的第三例。由于急诊科是器官获取的关键场所，急诊医生必须意识到死于一氧化碳暴露的患者可能是可接受的器官供体。
