29例脑死亡器官移植供体的维护体会

【摘要】 目的 探讨脑死亡器官移植供体在ICU的维护要点。方法〓回顾性分析我科2012年1月~2013年12月间完成的29例脑死亡供体器官捐献资料,分析脑死亡供体器官获取前情况,移植肾、移植肝受者情况及急性肾损伤(AKI)供肾的移植效果,总结脑死亡患者作为潜在供体的维护要点。结果〓维护脑死亡供体29例,共捐献肾脏40个、肝脏27个、心脏4个、角膜21对。6例(15%)移植肾受者发生移植物功能延迟恢复,1例(2.5%)发生急性排斥反应、1例(2.5%)发生髂内动脉假性动脉瘤出血切除移植肾,1例(2.5%)发生重症肺炎术后死亡;AKI供肾与非AKI供肾的受者在术后7天、2月肌酐恢复情况及不良事件发生率比较无明显差异;1例(4%)移植肝受者发生多脏器功能衰竭术后死亡。余受者随访至今均恢复顺利,器官功能良好。结论〓经过ICU内积极管理后的潜在器官移植供体能够获得较高质量的移植器官,有较好的移植效果。

Management of 29 cases brain death organ donor in the Intensive Care Unit

【Abstract】〓Objective〓To explore the management of potential organ donors after brain death in the Intensive Care Unit. Methods〓The clinical data of 29 cases of brain death organ donor from January 2012 to December 2013 in our Intensive Care Unit were analyzed retrospectively,including condition of pre-organ procurement,renal transplant recipients,liver transplant recipients and effect of renal transplantation on the recipients recived acute kidney injure(AKI) donors. Results〓Twenty-nine cases of brain death donor were managed for transplantation, including 40 kidneys,27 livers,4 hearts and 21 pairs of corneas. Renal delayed graft function occurred in 6 cases (15%) of renal transplant recipients. Acute rejection occurred in one case (2.5%) and internal iliac artery pseudoaneurysm also occurred in one case (2.5%) of renal transplant recipients, and the two cases subjected to nephrectomy. There was one case (2.5%) of renal transplant recipients death due to severe pneumonia. The recipients receive AKI kidney and non-AKI kidney had no significant difference on recovery of creatinine after operation and adverse event rates. There was one case (4%) of liver transplant recipients death due to multiple organ dysfunction syndrome. The rest of recipients were followed up and the grafts functioned well. Conclusion〓Better quality organs and transplant outcomes can be achieved by positive evaluation and management of the potential organ donor in the Intensive Care Unit.