Clinical application of ECMO in protecting donor liver in organ donation after citizen's death
10.3969/j.issn.1674-7445.2019.05.021
- VernacularTitle:ECMO技术在公民逝世后器官捐献供肝保护中的临床应用
- Author:
Limin DING
1
;
Xinchang LI
;
Zhidan XU
;
Xiaogang YANG
;
Xiaomei HUANG
;
Wenfeng LUO
Author Information
1. Department of Organ Transplantation, Jiangxi Provincial People's Hospital, Nanchang 330006, China
- Publication Type:Research Article
- Keywords:
Extracorporeal membrane oxygenation;
Donation after citizen's death;
Donation after brain death followed by cardiac death (DBCD);
Liver transplantation;
Donor liver protection;
Liver function;
Biliary tract stenosis;
Portal vein thrombosis
- From:
Organ Transplantation
2019;10(5):594-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of extracorporeal membrane oxygenation (ECMO) in protecting the donor liver in donation after citizen's death. Methods Clinical data of 16 donors and recipients undergoing liver transplantation using ECMO to protect the donor liver were retrospectively analyzed. The effect of ECMO on different indicators of the donors was evaluated. The liver function and clinical prognosis of the recipients after liver transplantation were observed. Results Compared with the time before ECMO, the heart rate, total bilirubin (TB), alanine transaminase (ALT) and aspartate transaminase (AST) of the donors after ECMO were significantly reduced, whereas the systolic blood pressure, diastolic blood pressure and partial pressure of arterial oxygen (PaO2) were remarkably increased (all P < 0.05). The liver function of the recipients was properly recovered after liver transplantation, and gradually restored normal at postoperative 7 to 28 d. Postoperative complications occurred in 3 recipients, including delayed liver function recovery in 1 case, biliary tract stenosis in 1 case and portal vein thrombosis in 1 case. Among them, the patient with portal vein thrombosis died after secondary operation, and the other 2 patients were recovered and discharged after symptomatic treatment. Conclusions The hemodynamics, liver function and other indicators of donors from donation after citizen's death are significantly improved after ECMO, and the liver function of the recipients also recover well.
