体外膜肺氧合在器官移植供体支持中的应用

Application of extracorporeal membrane oxygenation in supporting organ transplant donors

目的 探讨在器官移植前体外膜肺氧合（ECMO）对呼吸循环不稳定供体支持的作用.方法 分析4例脑死亡器官捐献（DBD）患者,紧急行ECMO支持,辅助9.5 ～78.0 h待肝肾功能得到一定改善及相关程序完毕后手术获取供肝和供肾.结果 4例患者分别辅助78.0、32.0、9.5、14.0h,内环境稳定,肝肾功能得到一定改善.获得的2个肾脏因实变弃用,其余10个器官均顺利移植,术后2例出现移植肾功能延迟恢复,10例受者痊愈出院.结论 ECMO对移植供体可以提供有效的呼吸循环支持,改善器官功能,为移植赢得充足时间,有效弥补了我国器官移植供体紧缺的现状.

Objective To investigate the supporting effect of extracorporeal membrane oxygenation （ECMO） for respiratory and circulatory instability donors before organ transplantation.Methods During September 2013 to August 2014,4 cases of donation after braindeath （DBD） patients were treated in our hospital.All of 4 cases were treated emergently with ECMO supporting for 9.5-78.0 h,and liver and kidney were removed after liver and kidney functions were improved to some extent and medical procedures completed.Results Four cases were supported for 78.0,32.0,9.5 and 14.0 h,respectively.Internal environment of body was stable.The liver and kidney functions were improved to varying degrees.Four livers and 6 kidneys obtained were successfully transplanted,andf 2 kidneys were abandoned for consolidation.After surgery 2 cases had delayed renal graft function.Ten recipients recovered.Conclusion Donor can be improved by ECMO,which can provide effective support of the respiration and circulation,and improve the function of organs.