器官捐献失败105例原因分析  

Analysis of the reasons for 105 cases of failed organ donation

作　　者：杨春华[1] 陈雪霞[1] 郑东华[1] 陈丽[1] 丁玉伟[1] 谢文锋[1] 

机构地区：[1]中山大学附属第一医院急诊科,广州510080

出　　处：《广东医学》2016年第10期1474-1476,共3页Guangdong Medical Journal

基　　金：广东省自然科学基金资助项目(编号:S2013010015328)

摘　　要：目的探讨提高器官捐献成功率的途径。方法回顾分析有器官捐献意愿的105例患者的捐献失败及器官维护不力原因。结果 (1)61例因严重器官功能不全或衰竭不能捐献,其中因维护不力在器官获取组织(OPO)到达前心跳停止38例,因肝肾功能衰竭未能捐献23例;(2)未达脑死亡标准24例,其中植物状态19例,高位截瘫并缺氧性脑病未达脑死亡标准2例,肌无力致严重呼吸衰竭3例;(3)其他原因20例,其中家中老人反对12例,要求有偿4例,家属要求捐献后与受者见面2例,百草枯中毒1例,中介介入1例。(4)61例严重器官功能不全或衰竭者中,严重低血容量58例,严重内环境紊乱35例,应用大剂量升压药61例,无一例应用T4。结论相关人员对脑死亡的判定和脑死亡后器官功能维护等知识的不足是最终捐献失败的主要原因。Objective To identify a method of improving the success rate of organ donation. Methods We perform a retrospective analysis of the reasons of 105 failure cases and the reasons of invalid organ maintenance who have wi- shes for organ donation from July 2011 to April 2014. Results 1. 61 cases had a failed donation because of severe organ dysfunction or failure, among which 38 cases had a cardiac arrest before OPO arriving and 23 cases had severe hepatorenal failure. 2. 24 cases did not meet the standard of brain death, among which 19 cases were in a vegetative state, 2 cases were paraplegia with anoxic encephalopathy but not brain death, 3 cases were loss of muscle tone leading to severe respiratory failure. 3. 20 cases were for other reasons, among which 12 cases were because of disagreement from elder family members, 4 cases required to be paid, 2 cases＇ family wanted to meet with the transplant recipients, 1 case with paraquat poisoning, 1 case with thirdparty intervention. 4. Among the 61 failure cases with severe organ dysfunction, 58 cases developed severe hypovolemia, 35 cases had severe internal environment disorder, 61 cases received large doses of vasopressors, 0 cases with application of T4. Conclusion Insufficient training and education of involved practitioners on determination of brain death, maintenance of organ functions after brain death is the main reason leading to unsuccessful organ donation.

关 键 词：脑死亡 器官捐献 原因 

分 类 号：R617[医药卫生—外科学]