体外膜肺氧合技术在器官捐献供体维护中的应用

Application of Extracorporeal Membrane Oxygenation in the Maintenance of Organ Donors

器官移植是终末期器官功能衰竭的主要治疗手段.目前,移植器官主要来源于死亡后器官捐献.根据器官获取前的死亡判定标准可分为心脏死亡器官捐献(DCD)和脑死亡器官捐献(DBD).但无论哪种类型捐献,供体器官均面临缺血及缺氧、组织灌注不足等问题,影响器官质量及受体预后.因此,维护及改善供体器官质量,增加边缘供体数量,成为目前亟待解决的问题.体外膜肺氧合(ECMO)部分替代患者心泵血功能,维持循环稳定,增加组织灌注,从而改善器官质量,提高器官获取几率,降低移植后不良事件的发生率,改善受者预后.近年来,ECMO在器官捐献领域中的应用正在扩大和发展.本文就ECMO在器官捐献中的应用进展及所面临的问题做一综述.

Organ transplantation is the main treatment for end-stage organ failure.At present,transplanted organs mainly come from organ donation after death,which can be divided into cardiac dead organ donation(DCD)and brain dead organ donation(DBD)according to the death judgment criteria before organ acquisition.However,no matter what type of donation,donor organs are faced with ischemia,hypoxia,insufficient tissue perfusion and other problems,which affect organ quality and receptor prognosis.Therefore,maintaining and improving the quality of donor organs and increasing the number of marginal donors have become urgent problems to be solved.Extracorporeal membrane oxygenation(ECMO)partially replaces the cardiac pumping function of patients,maintains stable circulation and increases tissue perfusion,so as to improve the organ quality,increase the probability of organ acquisition,reduce the incidence of adverse events after transplantation and improve the prognosis of recipients.In recent years,the application of ECMO in organ donation has been expanding and developing.This paper reviews the application progress and problems of ECMO in organ donation.