儿童器官捐献供体肝肾联合获取经验总结

目的  探讨儿童器官捐献供体肝肾联合获取的临床经验。方法  收集2011年10月至2016年12月佛山市第一人民医院6例儿童器官捐献供体肝肾联合获取的临床资料，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儿童脑死亡判定标准，6例儿童供体均在脑死亡状态下进行器官捐献肝肾联合获取，采用7号吸痰管髂外动脉插管或24 F导尿管髂总动脉插管、门静脉和腹主动脉灌注、胸主动脉阻断的肝肾联合灌注的改良方法。手术时间55~60 min，共成功获取6个供肝、12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  在儿童器官捐献供体中成功进行肝肾联合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肝肾联合获取技术的改良。

Experience summary of combined liver and kidney procurement from pediatric organ donation

Objective To summarize the clinical experience of combined liver and kidney procurement from pediatric organ donation. Methods Clinical data of 6 pediatric donors undergoing combined liver and kidney procurement in the First People's Hospital of Foshan from October 2011 to December 2016 were collected and relevant clinical experience was summarized. Results According to the diagnostic criteria for brain death (for children) established by Brain Injury Evaluation Quality Control Center of National Health and Family Planning Commission, 6 pediatric donors received combined liver and kidney procurement for organ donation under the status of brain death. Modified liverkidney perfusion was performed by external iliac arterial intubation using No.7 suction catheter, or arteria iliaca communis intubation using 24 F catheter for the perfusion of portal vein and abdominal aorta, thoracic aorta occlusion. The operation time was 55-60 min. A total of 6 liver grafts and 12 renal grafts were harvested, which were successfully applied in clinical liver and renal transplantation. No primary nonfunction was observed in the liver or renal grafts. Conclusions Timely assessment of brain death, rigorous and cautious measures for organ maintenance and modified techniques for combined liver and kidney procurement play a key role in the success of combined liver and kidney procurement from pediatric organ donation.