中国组织工程研究Issue(5)：817-824,8.DOI:10.3969/j.issn.2095-4344.2013.05.009
儿童心脏死亡器官捐献与肾脏移植1例报告★
Renal allografts from pediatric donors after cardiac death:One case report
杨顺良 1郭君其 1张伟 2吴晓智 3高霞 1蔡锦全 1谭建明1
作者信息
- 1. 解放军南京军区福州总医院泌尿外科，全军器官移植研究所，福建省福州市350025
- 2. 解放军南京军区福州总医院急诊 ICU，福建省福州市350025
- 3. 解放军南京军区福州总医院麻醉科，福建省福州市350025
- 折叠
摘要
Abstract
BACKGROUND: The organ shortage is the common difficulty faced by the global transplant community. In order to expand the donor sources, to ease the growing tension of the organ shortage and to avoid confusion caused by the absence of brain death legislation and diagnostic criteria, the Ministry of Health and the Red Cross Society of China have jointly promote the cardiac death organ donation. OBJECTIVE: To investigate the feasibility of organ donation from pediatric donors after cardiac death. METHODS: One case of organ donation from a pediatric donor at Fuzhou General Hospital of Nanjing Military Command of PLA was retrospectively analyzed combined with the analysis of the literatures. RESULTS AND CONCLUSION: A 4-year-old boy was independently diagnosed with brain death after cardiopulmonary resuscitation by two groups of specialists at an interval of 24 hours. The criteria included the Diagnostic Criteria for Brain Death (for adults), the Technological Specification for Brain Death (for adults) and atropine test results. The donor parents should be informed and consent with the donor programs and ful y expressed the donation wil ingness, and the program should be approved by the hospital ethics committee. The fol owing steps including donation application, approval, transportation, organ maintaining, mechanical support removal and organ recovery were conducted according to the organ donation guidelines in China after cardiac death. The warm ischemia time was 13 minutes. Two renal grafts were transplanted to two uremic recipients selected by age, weight and human leukocyte antigen matching. The left kidney recipient was a 13-year-old female patient and the right kidney recipient was a 35-year-old female patient. No complications such as delayed graft function, renal graft vascular thrombosis, urinary fistula or ureteral obstruction were observed. The graft length was increased from 7 cm postoperation to 10 cm at 1 year after operation, with negative proteinuria, serum creatinine of 60 μmol/L and estimated glomerular filtration rate was ranged from 70 to 150 mL/min. No long term complications such as serious infections, hypertension, diabetes, hyperlipidemia or liver dysfunction were observed. The recipients have good levels of daily living activities, psychological status and adherence. Organ donation from pediatric donors after cardiac death was one of the alternative solutions to the shortage of organ sources in transitional period. We should explore the standardized operating procedures of pediatric donation after cardiac death based on the top priority principles of patient interests.关键词
器官移植/肾移植/心脏死亡/器官捐献/儿童/脑死亡/肾脏/热缺血时间/肾功能/伦理/并发症/组织配型Key words
organ transplantation/renal transplantation/cardiac death/organ donation/child/brain death/kidney/warm ischemia time/renal function/ethics/complications/tissue typing分类
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杨顺良,郭君其,张伟,吴晓智,高霞,蔡锦全,谭建明..儿童心脏死亡器官捐献与肾脏移植1例报告★[J].中国组织工程研究,2013,(5):817-824,8.
