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。
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.
出处
《岭南现代临床外科》
2015年第3期286-289,共4页
Lingnan Modern Clinics in Surgery
基金
广东省自然科学计划项目(2011B031800373)
关键词
脑死亡
重症监护病房
器官捐献
维护
Brain death
Intensive Care Unit
Organ donors
Management
