急性脑死亡对移植供体心脏形态学损害的研究

目的 探讨急性脑死亡对移植供体心脏形态学影响。方法 对7例急性脑外伤后脑死亡患者，紧急气管插管人工辅助呼吸，维持循环和呼吸的相对稳定，确定为供体后，开胸，主动脉根部阻断，心脏冷停跳液灌注，心脏停搏后，取出心脏，取小块右心房和右心室肌，进行光镜和电镜检查。结果 7例中有5例心肌的光镜显示肌原纤维间有水样变性，胞浆不均匀，肌原纤维之间有空隙，心肌内血管呈收缩状态；电镜下显示线粒体肿胀，有肌浆网扩张，部分区域有线粒体崩解，呈空胞变性。心肌细胞线粒体肿胀，脊断裂。结论 急性脑死亡可导致移植心脏形态学的损害，对心脏移植的效果具有一定影响。

Morphological observation of donor heart after acute brain death

Objective To study the donor heart morphological effect of brain death on heart transplantation.Methods Seven male cases,brain death due to acute brain trauma were treated with emergent endotracheal intubatton and assistant breath,circulation and respiration in opposite stabilization.After they were confirmed to be donors,the thorax was split,the root of aorta interdicted,and the heart perfused with cold perfusion liquid.After the heartbeat was stopped,took out the heart,removed small mass of muscle of right atrium and right ventricle,and observed the exemplar with optics microscope and electron microscope.Results Under optics microscope:5 of 7 cardiac muscle exemplar showed water denaturalization of myofibrilla.Cytochylema was asymmetrical.There were some interspaces between myofibrilla.The blood vessel in cardiac muscle was in the con- tractive situation.Under electron microscope:cardiac muscle chondriosome was swell,and raphe rupture.Sarcoplasmic reticulum was expanded.There was chondriosome collapse in some parts,and vacuole denaturalization.Conclusion Acute brain death can induce morphological damage of transplantation heart,it has certain effect on the result of heart transplantation.