公民逝世后器官捐献供肝质量评估和维护的体会

目的  总结公民逝世后器官捐献供肝质量评估和功能维护的经验。方法  回顾性分析2012年7月至2015年6月在中山大学附属第三医院器官移植中心成功实施的93例器官捐献供者和87例器官捐献供肝肝移植的临床资料。介绍该中心对供肝质量的评估和功能维护经验，总结器官捐献器官获取和利用的情况，以及接受器官捐献肝移植受体恢复情况。结果  供者器官的平均热缺血时间为8 min(1～12 min)，器官切取手术操作顺利，器官切取手术平均耗时为32 min(20～52 min)。93例供体获取了93个肝脏，成功用于肝移植87例，弃用6例(重度脂肪肝3例、肝纤维化2例、肝脏撕裂伤1例)，含2例肝肾联合移植。移植肝功能恢复良好，仅有1例出现原发性移植肝无功能。结论  对公民逝世后器官捐献的供者进行早期正确的评估和维护，能够提高移植器官质量，改善移植效果。

Experience of quality evaluation and function maintenance of donor liver from organ donation after citizen's death

Objective To summarize the experience of quality evaluation and function maintenance of donor liver from organ donation after citizen's death. Methods Clinical data of 93 donors and 87 patients undergoing liver transplantation in the Third Affiliated Hospital of Sun Yat-sen University form July 2012 to June 2015 were retrospectively analyzed. The experience of quality evaluation and function maintenance of donor liver was briefly introduced. The procurement and utilization of donor organs and the recovery of recipients undergoing donor liver transplantation were summarized. Results The mean warm ischemia time of donor organ was 8 min (1-12 min). The organ procurement surgery was successfully performed with an average duration of 32 min (20-52 min). In total, 93 donor livers were obtained, 87 utilized for liver transplantation and 6 discarded (3 cases of severe fatty liver disease, 2 of hepatic fibrosis and 1 of hepatic tearing injury). Two patients underwent combined liver and kidney transplantation. The function of liver graft recovered well. Merely 1 case presented with primary liver graft non-function. Conclusions Early and accurate evaluation and maintenance of donor livers from organ donation after citizen's death can enhance the quality of organ graft and improve the transplantation efficacy.