摘要
目的通过分析我院实施的心脏死亡器官捐献(DCD)移植病例,探讨国内DCD器官和移植方面的问题。方法对我院2010～2011年期间参与实施的DCD器官移植的临床资料进行回顾性总结。结果本组有4例DCD者共实施了7例肾移植和3例肝移植。捐献者1属于中国DCD器官分类标准(中国标准)二类(MaastrichtⅣ类),热缺血时间40 min,经快速病理检查后放弃了肝脏和左侧肾脏,右侧肾脏进行了移植后患者出现移植肾功能延迟恢复,最终移植肾因破裂出血而被切除。捐献者2～4属于中国标准三类(MaastrichtⅢ类),热缺血时间分别为15、15、10 min,其中捐献者4在器官捐献前已经出现血压下降,需要大剂量多巴胺维持血压,供肝进行了快速病理检查,确认可以使用;捐献者2和3由于是在手术室进行可控性心跳及呼吸终止,热缺血时间均为15 min,未进行病理学检查;共实施了3例肝移植和6例肾移植,手术顺利,移植物功能恢复良好,无并发症发生,无移植患者死亡。结论通过选择符合中国标准三类的捐献者,实施可控的DCD程序,DCD器官移植可以获得满意的效果。供体器官的快速病理检查有利于器官质量的判断,减少移植手术后并发症的发生。
Objective To approach the questions of donation after cardiac death（DCD）and transplantation through analyzing the DCD cases in this hospital.Methods The organs were obtained from 4 DCD from 2010 to 2011 in this hospital,the clinical data of DCD were analyzed retrospectively.Results Seven renal transplantations and 3 liver transplantations were performed.Donor warm ischemic time was 10-40 min.The liver and left kidney of the first DCD donator（Maastricht category Ⅳ）were eliminated through biopsy.One patient exhibited delayed graft function of kidney from the first DCD,the nephrectomy had to be done on day 7 after operation due to renal allograft rupture.Nine patients received 3 livers and 6 kidneys from the other 3 DCD donators（Maastricht category Ⅲ）,whose patients were alive with excellent graft function.Conclusions The use of controlled DCD（Maastricht category Ⅲ）might be an effective way to increase the number of organs available for transplantation because that it might obtain satisfactory transplant outcomes and acceptable postoperative complications.The widespread implementation of controlled DCD in China should be encouraged.
出处
《中国普外基础与临床杂志》
CAS
2012年第5期473-477,共5页
Chinese Journal of Bases and Clinics In General Surgery
关键词
心脏死亡器官捐献
肝脏移植
肾脏移植
Donation after cardiac death
Liver transplantation
Kidney transplantation
