目的 總結(jié)并進(jìn)一步探討心臟死亡器官捐獻(xiàn)(DCD)獲取流程的初步經(jīng)驗(yàn)。
方法 回顧性分析 2009年7月至 2012年1月期間廣州軍區(qū)總醫(yī)院28例DCD者的臨床資料、供體入選標(biāo)準(zhǔn)及器官獲取流程。
結(jié)果 28例DCD供體均成功實(shí)施了器官捐獻(xiàn),其中MaastrichtⅢ類 3例(10.7%),MaastrichtⅣ類1例(3.6%),腦-心雙死亡捐獻(xiàn)(DBCD)供體24例(85.7%)。3例MaastrichtⅢ類供體實(shí)施了標(biāo)準(zhǔn)DCD器官獲取流程(簡稱DCD流程),1例Maastricht Ⅳ類供體采用DBCD器官獲取流程(簡稱DBCD流程)非體外膜肺氧合(ECMO)模式,24例DBCD采用了DBCD流程ECMO模式。供體器官熱缺血時間:DBCD為0min,MaastrichtⅣ類為18min,MaastrichtⅢ類平均25min (22~28min)。本組共獲取了28個肝臟、40個腎臟、2個心臟,分別成功用于肝移植、腎移植和心臟移植。
結(jié)論 我國DCD器官獲取可分為DCD流程和DBCD流程,后者又分為ECMO模式和非ECMO模式。ECMO模式可避免器官熱缺血損傷且沒有倫理學(xué)爭議,對我國公民DCD器官有著十分重要的作用。
引用本文: 霍楓,汪邵平,李鵬,鄭于劍,蒲淼水,陳建雄,詹世林,何桓. 心臟死亡器官捐獻(xiàn)獲取流程探討. 中國普外基礎(chǔ)與臨床雜志, 2012, 19(5): 468-472. doi: 復(fù)制
版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編
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- 1. 腦死亡判定標(biāo)準(zhǔn)( 成人) ( 征求意見稿) [J]. 中華急診醫(yī)學(xué)雜志,2003, 12(2):142-144.
- 2. 衛(wèi)生部腦死亡判定標(biāo)準(zhǔn)起草小組. 腦死亡判定標(biāo)準(zhǔn)( 成人) ( 修訂稿) [J]. 中國腦血管病雜志, 2009, 6(4):220-224.
- 3. Lewis J, Peltier J, Nelson H, et al. Development of the University of Wisconsin donation after cardiac death evaluation tool [J].Prog Transplant, 2003, 13(4):265-273.
- 4. Kootstra G, Daemen JH, Oomen AP. Categories of non-heartbeating donors [J]. Transplant Proc, 1995, 27(5):2893-2894.
- 5. 中華人民共和國衛(wèi)生部醫(yī)療服務(wù)監(jiān)管司. 衛(wèi)生部辦公廳關(guān)于啟動心臟死亡捐獻(xiàn)器官移植試點(diǎn)工作的通知( 附件1 -中國心臟死亡器官捐獻(xiàn)分類標(biāo)準(zhǔn). doc)[EB/OL]. http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/s9968/201104/51516.htm.
- 6. Casavilla A, Ramirez C, Shapiro R, et al. Experience with liver and kidney allografts from non-heart-beating donors [J]. Transplant Proc, 1995, 27(5):2898.
- 7. Moers C, Leuvenink HG, Ploeg RJ. Donation after cardiac death:evaluation of revisiting an important donor source [J].Nephrol Dial Transplant, 2010, 25(3):666-673.
- 8. Chaib E, Massad E. The potential impact of using donations after cardiac death on the liver transplantation program and waiting list in the state of Sao Paulo, Brazil [J]. Liver Transpl, 2008,14(12):1732-1736.
- 9. UNOS. Critical pathway for donation after cardiac death[EB/OL].http://www.unos.org/docs/Critical_Pathway_DCD_Donor.pdf.
- 10. Shemie SD, Baker AJ, Knoll G, et al. National recommendations for donation after cardiocirculatory death in Canada:Donation after cardiocirculatory death in Canada[J]. CMAJ, 2006,175(8):S1.
- 11. Australian Organ and Tissue Donation and Transplantation Authority.National Protocol for Donation after Cardiac Death EB/OL].http://www.health.gov.au/internet/budget/publishing.nsf/Content/2009-2010_Health_PBS_sup3/$File/Australian%20 Organ%20and%20Tissue%20Donation%20and%20Transplantation% 20Authority.pdf.
- 12. Reich DJ, Mulligan DC, Abt PL, et al. ASTS recommended practice guidelines for controlled donation after cardiac death organ procurement and transplantation [J]. Am J Transplant,2009, 9(9):2004-2011.
- 13. Shemie SD, Hornby K. Donor organ management:survey of guidelines and eligibility criteria [EB/OL]. http://www.organsandtissues.ca/s/wp-content/uploads/2011/11/Organ-Donor-Guidelines.pdf.
- 14. Bernat JL,D’Alessandro AM, Port FK, et al. Report of a National conference on donation after cardiac death [J]. Am J Transplant, 2006, 6(2):281-291.
- 15. Devita MA, Brooks MM, Zawistowski C,et al. Donors after cardiac death:validation of identification criteria (DVIC) study for predictors of rapid death [J]. Am J Transplant, 2008, 8(2):432-441.
- 16. 霍楓, 汪邵平, 李鵬, 等. 公民心死亡器官捐獻(xiàn)肝移植 [J].中華消化外科雜志, 2012, 11(1):69-75.