Experience of quality evaluation and function maintenance of donor liver from organ donation after citizen's death
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摘要:
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。 Abstract: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. -
Key words:
- Donation after cardiac death /
- Donor /
- Evaluation /
- Maintenance /
- Liver transplantation
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[1] Watts RP, Thom O, Fraser JF. Inflammatory signalling associated with brain dead organ donation: from brain injury to brain stem death and posttransplant ischaemia reperfusion injury[J]. J Transplant, 2013:521369. http://cn.bing.com/academic/profile?id=1977853109&encoded=0&v=paper_preview&mkt=zh-cn [2] Mathur AK, Heimbach J, Steffick DE, et al. Donation after cardiac death liver transplantation: predictors of outcome[J]. Am J Transplant, 2010, 10(11):2512-2519. doi: 10.1111/ajt.2010.10.issue-11 [3] 蓝柳根, 秦科, 董建辉, 等.公民逝世后器官捐献供肝移植31例临床效果分析[J].器官移植, 2015, 6(5):316-321. http://www.organtranspl.com/CN/article/downloadArticleFile.do?attachType=PDF&id=8849Lan LG, Qin K, Dong JH, et al. Clinical effect analysis of liver transplantation from donation after citizen's death in 31 cases[J]. Organ Transplant, 2015, 6(5):316-321. http://www.organtranspl.com/CN/article/downloadArticleFile.do?attachType=PDF&id=8849 [4] 邓斐文, 陈焕伟, 甄作均, 等.高MELD评分终末期肝病患者接受中国公民逝世后器官捐献供肝肝移植的近期疗效评价[J].器官移植, 2015, 6(2):86-92. http://www.organtranspl.com/Public/Uploads/Wall/2016-01-11/20160111074831.pdfDeng FW, Chen HW, Zhen ZJ, et al. Short-term clinical efficacy of liver transplantation with organs from donation after Chinese citizens' death in patients with high model for end-stage liver disease score[J]. Organ Transplant, 2015, 6(2):86-92. http://www.organtranspl.com/Public/Uploads/Wall/2016-01-11/20160111074831.pdf [5] 傅斌生, 易慧敏, 易述红, 等.公民逝世后器官捐献肝移植单中心临床疗效分析及初步经验[J/CD].中华肝脏外科手术学电子杂志, 2015, 4(2):88-91. http://www.docin.com/p-1243408187.htmlFu BS, Yi HM, Yi SH, et al. Single-center analysis on curative effect of liver transplantation from organ donation by citizens after death and initial experience[J/CD]. Chin J Hepatic Surg (Electr Edit), 2015, 4(2):88-91. http://www.docin.com/p-1243408187.html [6] Ledinh H, Meurisse N, Delbouille MH, et al. Contribution of donors after cardiac death to the deceased donor pool: 2002 to 2009 University of Liege experience[J]. Transplant Proc, 2010, 42(10):4369-4372. doi: 10.1016/j.transproceed.2010.07.018 [7] Elias-Miro M, Massip-Salcedo M, Jimenez-Castro M, et al. Does adiponectin benefit steatotic liver transplantation?[J]. Liver Transpl, 2011, 17(9):993-1004. http://cn.bing.com/academic/profile?id=2035414701&encoded=0&v=paper_preview&mkt=zh-cn [8] Perera MT, Bramhall SR. Current status and recent advances of liver transplantation from donation after cardiac death[J]. World J Gastrointest Surg, 2011, 3(11):167-176. doi: 10.4240/wjgs.v3.i11.167 [9] Lee KW, Simpkins CE, Montgomery RA, et al. Factors affecting graft survival after liver transplantation from donation after cardiac death donors[J]. Transplantation, 2006, 82(12):1683-1688. doi: 10.1097/01.tp.0000250936.73034.98 [10] O'Neill S, Roebuck A, Khoo E, et al. A meta-analysis and meta-regression of outcomes including biliary complications in donation after cardiac death liver transplantation[J]. Transpl Int, 2014, 27(11):1159-1174. doi: 10.1111/tri.2014.27.issue-11 [11] Nguyen JH, Bonatti H, Dickson RC, et al. Long-term outcomes of donation after cardiac death liver allografts from a single center[J]. Clin Transplant, 2009, 23(2):168-173. doi: 10.1111/ctr.2009.23.issue-2 [12] Frongillo F, Lirosi MC, Sganga G, et al. Graft steatosis as a risk factor of ischemic-type biliary lesions in liver transplantation[J]. Transplant Proc, 2014, 46(7):2293-2294. doi: 10.1016/j.transproceed.2014.07.057 [13] Karpeta E, Czerwiński J, Wasiak D, et al. Risk factors in cadaveric donors of livers procured for elective and urgent recipients[J]. Transplant Proc, 2012, 44(7):2250-2252. doi: 10.1016/j.transproceed.2012.07.115 [14] Goldaracena N, Quiñonez E, Méndez P, et al. Extremely marginal liver grafts from deceased donors have outcome similar to ideal grafts[J]. Transplant Proc, 2012, 44(7):2219-2222. doi: 10.1016/j.transproceed.2012.07.113 [15] Loggi E, Micco L, Ercolani G, et al. Liver transplantation from hepatitis B surface antigen positive donors: a safe way to expand the donor pool[J]. J Hepatol, 2012, 56(3):579-585. doi: 10.1016/j.jhep.2011.09.016 [16] Monbaliu D, Pirenne J, Talbot D. Liver transplantation using donation after cardiac death donors[J]. J Hepatol, 2012, 56(2):474-485. doi: 10.1016/j.jhep.2011.07.004 [17] Le Dinh H, de Roover A, Kaba A, et al. Donation after cardio-circulatory death liver transplantation[J]. World J Gastroenterol, 2012, 18(33):4491-4506. doi: 10.3748/wjg.v18.i33.4491
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