脑死亡无偿器官捐献心脏移植二例

目的探讨脑死亡无偿器官捐献心脏移植在我国的可行性及保证手术成功的必要条件。方法分别于2006年7月1日和2006年8月16日完成二例脑死亡无偿器官捐献心脏移植。供体确诊为脑死亡后应用小剂量多巴胺维持稳定的血流动力学和满意尿量，维持良好的电解质酸碱平衡、血气交换和血球压积而没有明显心源性肺水肿。供、受体ABO血型一致，但例1供、受体体重相差50％。结果例1于术后第3天死于低心排综合征；例2痊愈出院，现已从事正常工作，生活质量良好。结论脑死亡无偿器官捐献心脏移植在我国可以得到开展；脑死亡患者必须有满意的血流动力学和尿量及良好的心脏收缩功能才能作为理想的心脏移植供体；供受体间体重相差不应超过20％。

Heart transplantation with donor hearts of brain death patients for 2 cases

Objective To assess the feasibility of heart transplantation with donor hearts of brain death patients in China. Methods On July 1 and August 16, 2006, two heart transplantation were performed with donor hearts of brain death patients. Before donor hearts were harvested, donors were maintained a good hemodynamic stability and urine output by low dose dopamine, and had satisfing acid base status, gas exchange, electrolytis and hemotocrit without pulmonary edema. Recipients received hearts from ABO identical donors, but first donor＇s weight was only 50% of the recipient＇s. Results The first case died of low cardiac output syndrome on the third post-transplant day. The second case survived with good life quality. Conclusion Heart transplantation with donor hearts of brain death patients is feasible in China. Brain death patients can be good donors only when they have a good hemodynamic stability,urlne output and cardiac function. The difference of donor-recipient weight matching should be less than 20%.