体外膜肺氧合在心脏死亡器官捐献中的应用

Application of extracorporeal membrane oxygenation on organ donation after cardiac death

心脏死亡器官捐献（DCD）中供者器官不可避免地要经历热缺血损伤，移植术后原发性移植物无功能、移植物丢失以及缺血性胆管疾病等并发症的发生率较高。因此，如何避免、减少或修复DCD器官热缺血损伤进而保护移植受者的安全是当前DCD研究的一个热点。广州军区广州总医院肝脏移植中心于2009年2月开始使用体外膜肺氧合（ECMO）对DCD器官进行保护，目前共完成了52例ECMO辅助下DCD器官获取，均获得满意疗效。ECMO对DCD器官热缺血损伤的保护和修复机制不仅在国际DCD器官移植领域显示出良好的应用前景，更是解决我国DCD热缺血损伤的有效方法。笔者认为：这些机制对进一步扩大ECMO在我国DCD的应用范围，建立适合我国国情的人体器官捐献和获取标准流程和技术规范具有十分重要的意义。

The donated organ after cardiac death would undergo warn ischemia injury inevitably, and the incidences of primary non-function of donated organs, transplanted organ loss and ischemic-type biliary lesions were increased. It is a para- mount research dilemma to devise how to avert, lessen and recover the warm ischemia organs after donation of cardiac death （DCD）. Since February 2009, the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation （ECMO） to protect the organs of DCD. The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation, and it is an important method to solve the problem of donor shortage in China. Spreading the application range of ECMO in DCD andestablishing the standard procedures and techniques in China is of great importance.