Practical Journal of Organ Transplantation(Electronic Version) ›› 2018, Vol. 6 ›› Issue (1): 39-44.

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Evatuation and management of donor hearts from brain death

  

  • Online:2018-01-20 Published:2021-06-24

脑死亡心脏供体的评估和管理方法探索

周巍,孔祥荣,王凯,柴军武,陈洪磊,薛奋龙,王维铁   

Abstract:

Objective To summarize the experience of donor heart evaluation and function maintenance from 37 cases of donation after brain death in our hospital. Methods From January 2013 to June 2017,37 cases of heart donation after brain death were evaluated in cardial surgery department,Tianjin First Center Hospital. Donor hearts were fromorgan donation from organ procurement organization(OPO),and the diagnoses of brain death were based on the China brain death criteria(adult). Results Transplantations were all performed with a double lumen venous anastomosis manner. The cold ischemia time was(45 ~ 370)min,aorta cross-clamping time was(55 ~ 110)min and cardiopulmonary bypass time was(125 ~ 190)min. The operations were successful in 36 patients. A cardiac dysfunction occurred after operation in 1 case whose body weight was 30% less than the donor. The patient recovered after treated with extracorporeal membrane oxygenation(ECMO),intra-aortic balloon pump(IABP)and continuous renal replacement therapy(CRRT)1 week later. Conclusion We can improve the utilization of donor hearts andthe long-term survival of heart transplantation recipients by a comprehensive evaluation of the donor and recipient

摘要:

目的 总结分析天津市第一中心医院 37 例脑死亡器官捐献供者供心的评估及维护经验。 方法 回顾性分析 2013 年 1 月-2017 年 6 月天津市第一中心医院心外科完成的 37 例脑死亡器官捐献供 心的评估、获取及移植手术的临床资料。供心来源于器官获取组织主导的公民器官捐献,脑死亡供者根据 《中国脑死亡判定标准(成人)》进行判定。结果 手术方法均采用双腔静脉法原位心脏移植术。冷缺血 时间 45 ~ 370 分钟,阻断时间 55 ~ 110 分钟,体外循环时间 125 ~ 190 分钟。36 例患者手术过程顺利, 1 例供体体重小于受体体重 30%,术后出现心功能不全,术后通过体外膜肺氧合(ECMO)联合主动脉内球 囊反搏(IABP),肾脏替代治疗(CRRT)1 周后恢复。结论 对于供体及受体的综合评估,有效的心脏供 体管理措施,可以提高心脏供体利用率,改善心脏移植远期生存率。