脑死亡器官捐献供体评估和供心选择临床分析  

Clinical analysis on donor evaluation and donor heart selection in brain-dead organ donation

作　　者：任琳玮 张熙伟 张辉[3] 张歆杰 刘伟国[4] 王东[3] REN Linwei;ZHANG Xiwei;ZHANG Hui;ZHANG Xinjie;LIU Weiguo;WANG Dong(School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,China;不详)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261053 [2]山东大学齐鲁医学院 [3]山东第一医科大学第一附属医院(山东省千佛山医院)心血管外科 [4]山东第一医科大学第一附属医院(山东省千佛山医院)临床药学科

出　　处：《山东医药》2024年第13期11-15,共5页Shandong Medical Journal

基　　金：山东省医药卫生科技发展计划项目(2018WS1078)。

摘　　要：目的总结73例脑死亡器官捐献供体评估和供心选择的临床经验。方法回顾73对脑死亡器官捐献心脏移植供受者临床资料,评估供体,选择供心,分析心脏移植受者生存情况和边缘供心使用情况。结果发现潜在供体,在判定脑死亡状态后,明确供体家属同意器官捐献后,评估供体,选择供心,使供受体最大限度匹配。73例心脏移植受者手术成功率为94.5%(69/73),围手术期死亡4例,术后随访1年死亡4例。边缘供心使用情况:供体年龄≥45岁17例,供受体体质量不匹配2例,供体中毒1例,供心冷缺血时间≥4 h 43例,大部分心脏移植受者予主动脉内球囊反搏和(或)体外膜肺氧合辅助,最终顺利出院。结论供受体最大限度匹配可使心脏移植患者获益最大;同时,适当放宽供心选择标准,增加供心数量,将为众多等待心脏移植患者带来希望。Objective To analyze the clinical experience of donor evaluation and heart selection in 73 cases of brain-dead organ donation.Methods The clinical data of 73 pairs of donors and recipients of heart transplantation from brain-dead organ donation were reviewed,the donor was evaluated,the donor heart was selected,and the survival situation of heart transplant recipients and the use of marginal donor hearts were analyzed.Results For potential donors,after deter-mining the brain death status and confirming the donor family's consent to organ donation,donors were evaluated and hearts were selected to maximize the matching of donors and recipients.The success rate of 73 heart transplant recipients was 94.5%(69/73),4 died during perioperative period,and 4 died after 1 year follow-up.Borderline donor:17 patients were aged≥45 years,2 patients had mismatched donor and recipient body mass,1 patient had donor poisoning,and 43 patients had cold ischemia time≥4 h.Most of the recipients were assisted by intra-aortic balloon counterpulsation and/or extracorporeal membrane oxygenation,and were discharged successfully.Conclusions The maximum matching of donor and recipient can achieve satisfactory clinical results in heart transplantation patients.At the same time,appropri-ately relaxing the selection criteria for heart donors and increasing the number of donor hearts will bring good news to many patients waiting for heart transplants.

关 键 词：心脏移植 脑死亡器官捐献 供体评估 供心选择 

分 类 号：R654.2[医药卫生—外科学]