摘要目的 观察体外膜肺氧合(ECMO)应用于循环功能不稳定的中国一类器官捐赠者的器官保护效果.方法 3例符合“中国心脏死亡器官捐献分类标准”中国一类标准的捐赠者,在器官获取前血流动力学极不稳定,部分器官功能出现不同程度受损.经股动、静脉插管,采用静脉-动脉转流,行ECMO.根据体重、血流动力学及血液气体分析结果,调整ECMO流量.转流时间为6～12 h,之后获取肝脏和肾脏用于移植.结果 3例行ECMO转流期间,血流动力学逐步稳定,血管活性药物应用明显减少,甚至停用,受损的器官功能明显恢复,最终获取肾脏6个和肝脏2个用于移植.6例肾移植受者手术顺利,术后发生原发性移植肾功能恢复延迟2例,急性排斥反应2例,移植肾功能恢复良好.结论 对于血流动力学不稳定的中国一类捐赠者,ECMO是保护器官的有效手段.

abstractsObjective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.