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The organ preservation and enhancement of donation success ratio effect of extracorporeal membrane oxygenation in circulatory unstable brain death donor.
Fan, Xiaoli; Chen, Zhiquan; Nasralla, David; Zeng, Xianpeng; Yang, Jing; Ye, Shaojun; Zhang, Yi; Peng, Guizhu; Wang, Yanfeng; Ye, Qifa.
Afiliação
  • Fan X; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Chen Z; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Nasralla D; Transplant Center, Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK.
  • Zeng X; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Yang J; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Ye S; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Zhang Y; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Peng G; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Wang Y; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China.
  • Ye Q; Zhongnan Hospital of Wuhan University, Transplant Center of Wuhan University, Wuhan, China. yqf_china@163.com.
Clin Transplant ; 30(10): 1306-1313, 2016 10.
Article em En | MEDLINE | ID: mdl-27460305
Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes. A total of 19 brain death donors were supported by ECMO. The incidence rate of post-transplant liver primary non-function (PNF) was 10% (two of 20) in DBD-drug group and zero in DBD-ECMO group. Kidney function indicators, including creatinine clearance and urine production, were significantly better in DBD-ECMO group, as well as the kidney delayed graft function (DGF) rate was found to be decreased by the use of ECMO in our study. Donation success rate increased steadily from 47.8% in 2011 to 84.6% in 2014 after the ECMO intervention. The use of ECMO in assisting circulatory and respiratory function of DBD can reduce liver and kidney injury from vasoactive drugs, thereby improving organ quality and reducing the organ discard rates.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Morte Encefálica / Oxigenação por Membrana Extracorpórea / Transplante de Rim / Transplante de Fígado / Coleta de Tecidos e Órgãos / Função Retardada do Enxerto Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2016 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Preservação de Órgãos / Morte Encefálica / Oxigenação por Membrana Extracorpórea / Transplante de Rim / Transplante de Fígado / Coleta de Tecidos e Órgãos / Função Retardada do Enxerto Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Transplant Assunto da revista: TRANSPLANTE Ano de publicação: 2016 Tipo de documento: Article País de afiliação: China