Leikin J B, Heyn-Lamb R, Aks S, Erickson T, Snyder J
Section of Emergency Medicine, Rush Presbyterian-St Luke's Medical Center/Toxikon Consortium, Chicago, IL 60612.
Am J Emerg Med. 1994 Mar;12(2):151-4. doi: 10.1016/0735-6757(94)90235-6.
The use of organs from poisoned victims for the purpose of transplantation has been poorly studied; criteria for organ donation is virtually non-existent in such cases. To further elucidate these indications, a retrospective review of all organ transplantation donated by poisoned victims in Northern and Central Illinois was undertaken. From January 1988 to December 1993, 17 poisoned victims were identified as having donated organs to 41 recipients. Eleven of the donors died as a direct result of drug toxicity, whereas six donors had drug-related deaths. The cases were reviewed for toxin involved, organ preoperative function and postoperative function (up to 1 year after transplant). Kidney transplants postoperative function was rated as good if creatinine was less than 1.9, fair if creatinine was 2 to 2.9, and poor if creatinine was 3. Donor age ranged from 2 years to 54 years. Toxins involved in donation included ethanol (n = 8), cocaine (n = 5), carbon monoxide (5), barbiturates (2) and lead (1), six patients had multiple drugs. Two of the nine recipients of livers died intraoperatively, both unrelated to organ function. Thirty-two kidneys were transplanted with 28 having good 10-day postoperative function, three having fair postoperative function, and one (cocaine donor) having poor postoperative function. One kidney transplanted from a cocaine donor had a thrombosed graft 5 days postoperatively. Deaths involving toxins in general does not seem to be a contraindication to donation of liver and kidney for transplantation.
关于将中毒受害者的器官用于移植的情况，相关研究较少；在此类情况下，几乎不存在器官捐赠的标准。为了进一步阐明这些指征，我们对伊利诺伊州北部和中部所有由中毒受害者捐赠的器官移植进行了回顾性研究。从1988年1月至1993年12月，共确定了17名中毒受害者向41名接受者捐赠了器官。其中11名捐赠者直接死于药物毒性，另外6名捐赠者的死亡与药物有关。我们对这些病例进行了审查，内容包括所涉及的毒素、器官术前功能和术后功能（移植后长达1年）。如果肌酐水平低于1.9，则肾移植术后功能评定为良好；如果肌酐水平为2至2.9，则评定为尚可；如果肌酐水平为3，则评定为差。捐赠者年龄从2岁至54岁不等。捐赠所涉及的毒素包括乙醇（n = 8）、可卡因（n = 5）、一氧化碳（5例）、巴比妥类药物（2例）和铅（1例），6名患者使用了多种药物。9名肝脏接受者中有2名在手术中死亡，均与器官功能无关。共移植了32个肾脏，其中28个术后10天功能良好，3个术后功能尚可，1个（来自可卡因捐赠者）术后功能差。1个从可卡因捐赠者移植的肾脏在术后5天出现移植血管血栓形成。一般来说，因毒素导致的死亡似乎并非肝、肾移植捐赠的禁忌证。
