脑死亡器官获取单中心经验探讨

The experience on organ procurement after brain death

目的探讨脑死亡器官捐献供体肝脏、肾脏获取的临床经验。方法回顾性分析2016年5月—2018年3月天津市第一中心医院12例脑死亡器官捐献供体肝脏、肾脏获取的临床资料,分析总结其临床经验。结果根据国家卫生和计划生育委员会脑损伤质控评价中心制定的脑死亡判定标准,12例供体均在脑死亡状态下进行器官捐献肝脏获取,采用天津市第一中心医院自制灌注管路髂总动脉插管、门静脉和腹主动脉灌注、胸主动脉阻断的方法。手术时间为40～60 min,共成功获取12个供肝、24个供肾,所获取肝、肾均成功应用于临床肝、肾移植,受者均未发生移植肝或移植肾原发性无功能。结论在脑死亡器官捐献供体中成功进行肝脏、肾脏获取的关键在于及时进行脑死亡判定、严格谨慎的器官维护措施和获取技术的改良。

Objective To discuss the clinical experience of liver and kidney procurement from donation after brain death(DBD)donors.Methods The clinical data of 12 DBD donors undergoing liver and kidney procurement in Tianjin First Central Hospital from May 2016 to March 2018 were analyzed retrospectively.The clinical experience was summarized.Results According to the diagnostic criteria for brain death established by Brain Injury Evaluation Quality Control Center of National Health and Family Planning Commission,the livers and kidneys of 12 DBD donors were procured after brain death.Modified liver and kidney perfusion was performed by arterial and portal vein intubation using the catheter made in Tianjin First Central Hospital.The operation time was 40~60 min.A total of 12 liver grafts and 24 renal grafts were harvested,those organs were successfully applied in clinical liver and renal transplantation.No primary nonfunction was observed in the liver or renal grafts.Conclusion Timely assessment of brain death,rigorous and cautious measurement for organ maintenance and modified techniques for combined liver and kidney procurement play a key roles in the success of liver and kidney procurement from DBD organ donation donors.