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62例器官捐献供肺的评估及维护经验总结

Experience of the selection and maintainence for donor lung:62 cases attached

摘要目的:总结器官捐献供肺的评估及维护经验。方法回顾性分析2015年1月至2016年6月共62例由广州医科大学附属第一医院胸外科进行评估的供肺资料。对所有供肺进行基本资料、体检、影像学检查、实验室检查、支气管镜检查,并进行数据的收集及整理分析,对符合肺移植要求的供肺进行获取并完成移植手术,而后进行随访。结果62例供肺最终获取40例,其中男性31例,女性9例,供者平均年龄28?7岁,其中脑死亡供者34例,心脏死亡供者6例。8例初始评估不合格的供肺,在进一步维护后均达到了肺移植的要求。在获取的40例供肺的支气管残端或肺组织标本中,发现了以肺炎克雷伯杆菌、鲍曼不动杆菌、金黄色葡萄球菌、屎肠球菌为主的细菌感染,细菌感染率为82?5%(33/40)。共完成22例双肺移植,17例单肺移植,1例心肺联合移植,共36例(90?0%)顺利度过围手术期。结论供肺的充分评估及维护可以提高捐献器官的使用率,同时发现不适合的供肺,减少医疗资源浪费。供肺的评估及维护是一个系统工作,需要多学科的共同参与。

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abstractsObjective To summarize the experience of selection and maintainence for the lungs from donation. Methods From January 2015 to June 2016, 62 cases had been evaluated by Department of Thoracic Surgery, First Affiliated Hospital of Guangzhou Medical University? All the clinic data had been collected to evaluate the donor lungs, including the basic information, physical examination, results of radiology and laboratory, the bronchoscope, etc? All the satisfactory donors had been harvested and transplanted to the receipient and then follow up? Results Forty cases of donor lung had been harvested from 62 cases? There were 31 male and 9 female cases with average age of 28?7 years? There were 34 cases form donation after brain death and 6 cases from donation after circulatory death? In addition, 8 cases which were considered to be the marginal donors became satisfied after the donor maintanence? The microbe in all 40 cases had been detected and the bacterial infection rate was 82?5% ( 33/40)? The microbe below could be detected in the bronchial stump or lung tissue, including Klebsiella Pneumonia, Baumanii, Staphylococcus Aureus, Enterococcus Faecium, etc? In the end, 22 bilateral lung transplantations, 17 single lung transplantations, 1 heart?lung transplantation had been implemented successfully and the survival rate in the perioperative period was 90?0%? Conclusions The utilization ratio of donation can be increased and the waste of medical resource in unacceptable donor can be reduced by the sufficient donor selection and maintanence? The participation of multi?department is needed in the process of donor selection and maintanence.

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中华外科杂志

中华外科杂志

2016年54卷12期

898-901页

MEDLINEISTICPKUCSCDCA

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