2例脑死亡无偿器官捐献供体的维护体会

目的探讨脑死亡器官移植供体的维护要点。方法我院于2011年12月至2012年1月期间共完成2例脑死亡器官捐献(DBD)供体的无偿器官捐献工作。供体确诊为脑死亡,应用机械通气、血管活性药物及其他相关药物维持供体,监测有创动脉压、中心静脉压、心率、血气交换、尿量、电解质酸碱平衡、体温、血细胞比容、白蛋白水平等,维持供体器官灌注。结果 2例DBD供体维持生命体征平稳,捐献的器官功能稳定正常。其中,供体1在入ICU后6 h确诊脑死亡,到实施器官捐献共维护33 h;供体2在入ICU后8 h确诊脑死亡,到实施器官捐献共维护31 h。捐献的肝脏、肾脏和角膜均成功移植于受体。结论 DBD供体维护是确保潜在供体器官成功捐献和捐献器官移植手术成功的关键因素之一,对有效提高捐献器官的利用率及缓解目前器官短缺状况起到很重要的作用。

Donor Maintenance of Organ Donation after Brain Death(Report of 2 Cases)

Objective To explore the donor maintenance points of donor donation after brain death(DBD).Methods From December 2011 to January 2012,two cases of organ DBD in our hospital were performed.After diagnosis of brain death,mechanical ventilation,fluid resuscitation,vasoactive drugs,inotropic drugs,and so on were used,and invasive arterial pressure,central venous pressure,heart rate,blood gas exchange,urine output,electrolyte and acid-base balance,body temperature,hematocrit,albumin level were monitored,the donors vital organ perfusion were successfully kept at acceptable level.Results The vital signs of two cases of DBD donors were stable.The livers,kidneys,and corneas were donated,and the functions were stable and normal.Case one was diagnosed for brain death 6 h after ICU admitted,the period from diagnosis to organ procurement was 33 h.Case two was diagnosed for brain death 8 h after ICU admitted,the period from diagnosis to organ procurement was 31 h.All transplanted organs,livers,kidneys,and corneas,were working well after operation.Conclusions Donor maintenance process of DBD is the cornerstone to ensuring successfully organ donation and transplantation,which is important to improve the utilization rate of donated organs,and release the severely shortage of organ.