毒蕈中毒供者供肾一例并文献复习  

A kidney donor with brain death from wild mushroom poisoning:a case report and literature review

作　　者：杨倩[1] 赵永恒[1] 李超[1] 孙洵[1] 胡伟 徐红忍 李立[1] Yang Qian;Zhao Yongheng;Li Chao;Sun Xun;Hu Wei;Xu Hongren;Li Li(Transplant Center,First people's hospital in Kunming,Kunming 650224,China)

机构地区：[1]昆明市第一人民医院器官移植中心,昆明650224

出　　处：《中华器官移植杂志》2020年第5期297-300,共4页Chinese Journal of Organ Transplantation

基　　金：国家外国专家局资助项目(外专培出字[2017]50578);昆明市卫生科技人才培养项目暨"十百千"工程(2016-sw(省)-57)。

摘　　要：目的报道1名毒蕈中毒脑死亡儿童供者供肾移植,探讨毒蕈中毒脑死亡者能否成为潜在器官捐献者及其捐献器官的评估办法。方法对毒蕈中毒潜在供者进行严格的临床病程观察、实验室及病理学评估。结果供者病变符合中毒性肝炎,器官获取时肾脏大体形态及实验室检查、病理学评估大致正常,2只肾脏分配给2例成人受者,肝脏弃用。经随访6个月,1例受者术后顺利恢复,另1例受者经过移植物功能延迟恢复后逐渐康复。结论当各项实验室生化指标正常、病理学检查未见禁忌,并且有充足的时间判断毒蕈中毒类型、观察各器官的损伤发展趋势以及等待毒素清除的情况下,毒蕈中毒脑死亡者有可能成为器官捐献者。Objective To report a pediatric organ donor with brain death due to wild mushroom poisoning to examine whether or not brain death caused by mushroom poisoning might become a potential organ donor and how to evaluate donated organs.Methods Strict clinical observations,laboratory tests and biopsy were performed for potential donor.Results This donor's clinical changes were consistent with toxic hepatitis.Gross morphology,laboratory examinations and pathological biopsy of two kidneys were generally normal during organ acquisition.Two kidneys were assigned to two adult recipients and liver was discarded.After a follow-up period of 6 months,one recipient recovered well while another gradually recovered after delayed graft function.Conclusions This extraordinary case provides some references for selecting potential donors of mushroom poisoning.When the donor's relevant laboratory tests are normal,there is no pathological contraindication,sufficient time is available for estimating the type of mushroom poisoning,observing the trends of organ damage and waiting for the toxin clearance,donor with brain death from wild mushroom poisoning may donate organ.

关 键 词：毒蕈中毒 供者 肾移植 移植物功能恢复延迟 急性肾损伤 

分 类 号：R699.2[医药卫生—泌尿科学]