Swanson-Biearman B, Krenzelok E P, Snyder J W, Unkle D W, Nathan H M, Yang S L
Pittsburgh Poison Center, Children's Hospital of Pittsburgh, PA 15213.
J Toxicol Clin Toxicol. 1993;31(1):95-9. doi: 10.3109/15563659309000376.
Demand for viable human organs for transplantation continues to exceed the supply. To expand supply, the criteria for identification and management of suitable donors must continue to evolve. Poisoned patients are often excluded as potential organ donors due to perceived risks of transmittable agents and/or physiologically compromised organs. In this report, a patient succumbed after an intentional ingestion of cyanide and multiple pharmaceuticals. Donor organ viability was determined by lack of significant injury beyond the central nervous system. Following standard procurement procedures, the heart, liver, corneas, 16 skin grafts and 16 bone grafts were deemed suitable and successfully transplanted. All organ recipients were doing well eight months post transplantation. The focus of procurement personnel should be on tissue injury and not on the mere presence of clinical effect of a toxic agent. With the paucity of organs available, poison centers need to be cognizant of this dilemma when faced with a toxicologically compromised potential organ donor.
对可用于移植的人体活体器官的需求持续超过供应。为了扩大供应，合适供体的识别和管理标准必须不断发展。中毒患者往往因存在可传播病原体风险和/或器官生理功能受损而被排除在潜在器官供体之外。在本报告中，一名患者因故意摄入氰化物和多种药物后死亡。供体器官的存活能力取决于中枢神经系统以外无明显损伤。按照标准获取程序，心脏、肝脏、角膜、16块皮肤移植物和16块骨移植物被认为合适并成功移植。所有器官接受者在移植后八个月情况良好。获取人员的重点应放在组织损伤上，而不仅仅是有毒物质临床效应的存在。鉴于可用器官匮乏，毒物中心在面对毒理学上有问题的潜在器官供体时需要认识到这一困境。
