切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2017, Vol. 03 ›› Issue (02) : 85 -90. doi: 10.3877/cma.j.issn.2096-1537.2017.02.002

所属专题: 重症医学 文献

专家论坛

ICU器官捐献的供体管理
朱艳平1, 蔡常洁1, 管向东1,()   
  1. 1. 510080 广州,中山大学附属第一医院重症医学科
  • 收稿日期:2017-05-03 出版日期:2017-05-28
  • 通信作者: 管向东

ICU management of organ donor

Yanping Zhu1, Changjie Cai1, Xiangdong Guan1,()   

  1. 1. Department of Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2017-05-03 Published:2017-05-28
  • Corresponding author: Xiangdong Guan
  • About author:
    Corresponding author: Guan Xiangdong, Email:
引用本文:

朱艳平, 蔡常洁, 管向东. ICU器官捐献的供体管理[J]. 中华重症医学电子杂志, 2017, 03(02): 85-90.

Yanping Zhu, Changjie Cai, Xiangdong Guan. ICU management of organ donor[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(02): 85-90.

器官移植是提高终末期器官衰竭患者生存率和生活质量的最佳治疗方法,因此器官短缺也成为严峻的医疗和社会问题。器官捐献供体的早期识别和ICU的目标导向管理,可以增加器官获取率和改善器官功能。

Organ transplantation is the best way to improve survival and quality of life in patients with end-stage organ failure. The shortage of organs has become a serious health-care issue and social problem. Early identification of potential organ donor and goal-directed management in intensive care unit can increase the rate of donate organ harvesting and improve organ function.

表1 国际DCD分类及其特点[3]
表2 DBD/DBCD管理目标[4]
1
Wolfe RA, Ashby VB, Milford EL, et al. Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant[J]. N Engl J Med, 1999, 341(23): 1725-1730.
2
Abuanzeh R, Hashmi F, Dimarakis I, et al. Early donor management increases the retrieval rate of hearts for transplantation in marginal donors[J]. Eur J Cardiothorac Surg, 2015, 47(1): 72-77.
3
Maciel CB, Greer DM. ICU Management of the Potential Organ Donor: State of the Art[J]. Curr Neurol Neurosci Rep, 2016, 16(9): 86.
4
Citerio G, Cypel M, Dobb GJ, et al. Organ donation in adults: a critical care perspective[J]. Intensive Care Med, 2016, 42(3): 305-315.
5
中华人民共和国国家卫生和计划生育委员会, 国家卫生计生委医政医管局. 卫生部办公厅关于启动心脏死亡捐献器官移植试点工作的通知[EB/OL]. (2011-05-03)

URL    
6
霍枫,汪邵平,李鹏, 等. 公民心死亡器官捐献肝移植[J]. 中华消化外科杂志, 2012, 11(1): 69-72.
7
Shemie SD, Hornby L, Baker A, et al. International guideline development for the determination of death[J]. Intensive Care Med, 2014, 40(6): 788-797.
8
Potts JT, Herdman R. Non-Heart-Beating Organ Transplantation: Medical and Ethical Issues in Procurement[M]. Washington (DC): National Academies Press (US), 1997.
9
国家卫生和计划生育委员会脑损伤质控评价中心. 脑死亡判定标准与技术规范(成人质控版)[J]. 中国现代神经疾病杂志, 2015, 15(12): 935-939.
10
Bugedo G, Bravo S, Romero C, et al. [Management of the potential organ donor][J]. Rev Med Chil, 2014, 142(12): 1584-1593.
11
Anthony DC, Couch Y, Losey P, et al. The systemic response to brain injury and disease[J]. Brain Behav Immun, 2012, 26(4): 534-540.
12
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, 2013: 521369.
13
Smith M. Physiologic changes during brain stem death--lessons for management of the organ donor[J]. J Heart Lung Transplant, 2004, 23(9 Suppl): S217-S222.
14
Chen EP, Bittner HB, Kendall SW, et al. Hormonal and hemodynamic changes in a validated animal model of brain death[J]. Crit Care Med, 1996, 24(8): 1352-1359.
15
Al-Khafaji A, Elder M, Lebovitz D J, et al. Protocolized fluid therapy in brain-dead donors: the multicenter randomized MOnIToR trial[J]. Intensive Care Medicine, 2015, 41(3): 418-426.
16
Kotloff RM, Blosser S, Fulda GJ, et al. Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement[J]. Crit Care Med, 2015, 43(6): 1291-1325.
17
Wood KE, Becker BN, McCartney JG, et al. Care of the potential organ donor[J]. N Engl J Med, 2004, 351(26): 2730-2739.
18
Schnuelle P, Gottmann U, Hoeger S, et al. Effects of donor pretreatment with dopamine on graft function after kidney transplantation: a randomized controlled trial[J]. JAMA, 2009, 302(10): 1067-1075.
19
Wang Z, Guan W, Han Y, et al. Stimulation of Dopamine D3 Receptor Attenuates Renal Ischemia-Reperfusion Injury via Increased Linkage With Galpha12[J]. Transplantation, 2015, 99(11): 2274-2284.
20
Munshi L, Keshavjee S, Cypel M. Donor management and lung preservation for lung transplantation[J]. Lancet Respir Med, 2013, 1(4): 318-328.
21
Mascia L, Pasero D, Slutsky AS, et al. Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation: a randomized controlled trial[J]. JAMA, 2010, 304(23): 2620-2627.
22
Minambres E, Perez-Villares JM, Chico-Fernandez M, et al. Lung donor treatment protocol in brain dead-donors: A multicenter study[J]. J Heart Lung Transplant, 2015, 34(6): 773-780.
23
Minambres E, Ballesteros MA, Rodrigo E, et al. Aggressive lung donor management increases graft procurement without increasing renal graft loss after transplantation[J]. Clin Transplant, 2013, 27(1): 52-59.
24
Prodhan P, Casavant D, Medlock MD, et al. Inhaled nitric oxide in neurogenic cardiopulmonary dysfunction: implications for organ donation[J]. Transplant Proc, 2004, 36(9): 2570-2572.
25
Ware LB, Landeck M, Koyama T, et al. A randomized trial of the effects of nebulized albuterol on pulmonary edema in brain-dead organ donors[J]. Am J Transplant, 2014, 14(3): 621-628.
26
Levin K, Kotecha S, Westall G, et al. How can we improve the quality of transplantable lungs[J]? Expert Rev Respir Med, 2016, Oct 3: 1-7.
27
Dikdan GS, Mora-Esteves C, Koneru B. Review of randomized clinical trials of donor management and organ preservation in deceased donors: opportunities and issues[J]. Transplantation, 2012, 94(5): 425-441.
28
Sharpe MD, van Rassel B, Haddara W. Oral and intravenous thyroxine (T4) achieve comparable serum levels for hormonal resuscitation protocol in organ donors: a randomized double-blinded study[J]. Can J Anaesth, 2013, 60(10): 998-1002.
29
Pinsard M, Ragot S, Mertes PM, et al. Interest of low-dose hydrocortisone therapy during brain-dead organ donor resuscitation: the CORTICOME study[J]. Crit Care, 2014, 18(4): R158.
30
Mi Z, Novitzky D, Collins JF, et al. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors[J]. Clin Epidemiol, 2014, 7: 17-27.
31
Lumbreras C, Sanz F, Gonzalez A, et al. Clinical significance of donor-unrecognized bacteremia in the outcome of solid-organ transplant recipients[J]. Clin Infect Dis, 2001, 33(5): 722-726.
32
Singh N. Impact of donor bacteremia on outcome in organ transplant recipients[J]. Liver Transpl, 2002, 8(10): 975-976.
33
Fishman JA, Greenwald MA, Grossi PA. Transmission of infection with human allografts: essential considerations in donor screening[J]. Clin Infect Dis, 2012, 55(5): 720-727.
34
Westphal GA, Garcia VD, Souza RL, et al. Guidelines for the assessment and acceptance of potential brain-dead organ donors[J]. Rev Bras Ter Intensiva, 2016, 28(3): 220-255.
35
Lewis JD, Sifri CD. Multidrug-Resistant Bacterial Donor-Derived Infections in Solid Organ Transplantation[J]. Curr Infect Dis Rep, 2016, 18(6): 18.
36
Simkins J, Muggia V. Favorable outcome in a renal transplant recipient with donor-derived infection due to multidrug-resistant Pseudomonas aeruginosa[J]. Transpl Infect Dis, 2012, 14(3): 292-295.
37
Fischer SA, Lu K. Screening of donor and recipient in solid organ transplantation[J]. Am J Transplant, 2013, 13 Suppl 4: 9-21.
38
McKeown DW, Bonser RS, Kellum JA. Management of the heartbeating brain-dead organ donor[J]. Br J Anaesth, 2012, 108 Suppl 1: i96-i107.
39
Niemann CU, Feiner J, Swain S, et al. Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function[J]. N Engl J Med, 2015, 373(5): 405-414.
40
Fan X, Chen Z, Nasralla D, et al. The organ preservation and enhancement of donation success ratio effect of extracorporeal membrane oxygenation in circulatory unstable brain death donor[J]. Clin Transplant, 2016, 30(10): 1306-1313.
41
Migliaccio ML, Zagli G, Cianchi G, et al. Extracorporeal membrane oxygenation in brain-death organ and tissues donors: a single-centre experience[J]. Br J Anaesth, 2013, 111(4): 673-674.
42
Teng-Wei C, Chung-Bao H, Chan DC, et al. Marked elevation of hepatic transaminases in recipients of an orthotopic liver transplant from a brain-dead donor receiving extracorporeal membrane oxygenation[J]. Ann Transplant, 2014, 19: 680-687.
43
Bernat JL, Capron AM, Bleck TP, et al. The circulatory-respiratory determination of death in organ donation[J]. Crit Care Med, 2010, 38(3): 963-970.
44
Reich DJ, Mulligan DC, Abt PL, et al. ASTS recommended practice guidelines for controlled donation after cardiac death organ procurement and transplantation[J]. Am J Transplant, 2009, 9(9): 2004-2011.
45
Detry O, Le Dinh H, Noterdaeme T, et al. Categories of donation after cardiocirculatory death[J]. Transplant Proc, 2012, 44(5): 1189-1195.
46
Bernat JL, D′Alessandro AM, Port FK, et al. Report of a National Conference on Donation after Cardiac Death[J]. Am J Transplant, 2006, 6(2): 281-291.
47
Maciel CB, Hwang DY, Greer DM. Organ donation protocols[J]. Handb Clin Neurol, 2017, 140: 409-439.
[1] 陈舜, 薛恩生, 叶琴. PDCA在持续改进超声危急值管理制度中的价值[J]. 中华医学超声杂志(电子版), 2023, 20(09): 974-978.
[2] 杨皓媛, 龚杰, 邹青伟, 阮航. 哮喘孕妇的母婴不良妊娠结局研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 522-529.
[3] 蔡柔妹, 曾洁梅, 黄伟丽, 谢文敏, 刘燕丹, 吴漫君, 蔡楚燕. 利用QC小组干预降低经烧伤创面股静脉置管导管相关性感染发生率的临床观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(05): 399-404.
[4] 中华医学会器官移植学分会, 中国医师协会器官移植医师分会, 上海医药行业协会. 中国肝、肾移植受者霉酚酸类药物应用专家共识(2023版)[J]. 中华移植杂志(电子版), 2023, 17(05): 257-272.
[5] 江文诗, 何湘湘. 全球及我国器官捐献发展特征分析与学科建设[J]. 中华移植杂志(电子版), 2023, 17(05): 280-286.
[6] 中国康复医学会器官移植康复专业委员会. 成人实体器官移植后糖尿病管理专家共识[J]. 中华移植杂志(电子版), 2023, 17(04): 205-220.
[7] 王敏, 蒋家斌, 李茂新. 预警宣教联合个性化疼痛管理对腹股沟疝手术患者的影响[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 764-767.
[8] 朱青青, 卫贞祺. 腹股沟疝患者围手术期自我能效管理探讨[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 773-777.
[9] 闵筱兰, 周洁超, 陈振添. 健康管理联合心理干预用于腹腔镜腹股沟疝手术患儿术后效果观察[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(05): 657-661.
[10] 杨聚荣. 透析患者妊娠的管理[J]. 中华肾病研究电子杂志, 2023, 12(05): 300-300.
[11] 中华医学会骨科分会关节学组. 中国髋、膝关节置换日间手术围手术期管理专家共识[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 321-332.
[12] 王军, 刘鲲鹏, 姚兰, 张华, 魏越, 索利斌, 陈骏, 苗成利, 罗成华. 腹膜后肿瘤切除术中大量输血患者的麻醉管理特点与分析[J]. 中华临床医师杂志(电子版), 2023, 17(08): 844-849.
[13] 索利斌, 刘鲲鹏, 姚兰, 张华, 魏越, 王军, 陈骏, 苗成利, 罗成华. 原发性腹膜后副神经节瘤切除术麻醉管理的特点和分析[J]. 中华临床医师杂志(电子版), 2023, 17(07): 771-776.
[14] 谢国晓, 赵凌霞, 薛雪花. 慢性病管理模式在糖尿病社区管理中的应用[J]. 中华临床医师杂志(电子版), 2023, 17(05): 587-590.
[15] 刘雪云, 范颖, 姚爱军, 张胜苗, 吕亚妮, 张冰清, 张晓宇, 刘恒. 基于微信小程序的个体化、全程护理干预对孕妇孕期体重及分娩结局的影响[J]. 中华临床医师杂志(电子版), 2023, 17(04): 455-460.
阅读次数
全文


摘要