Applications of extracorporeal membrane oxygenation and continuous renal replacement therapy for maintaining organs of potential organ donors with cardiopulmonary failure after brain death

Mingkun Zhao, Chuansheng Xu, Feng Wang
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Abstract

Objective To explore the functions of extracorporeal membrane oxygenation (ECMO) with continuous renal replacement therapy (CRRT) for potential organ donors with cardiopulmonary failure after brain death and boost the coefficient of utilization of livers. Methods Analysis was conducted for clinical data of 5 donors with cardiopulmonary failure after brain death and their corresponding recipients from July 2015 to May 2017. Five donors received the treatments of ECMO and CRRT. The relevant data included changes of blood pressure, dosage of vasoactive agents, liver function, renal function and urine volume of those treated donors. Also liver functions of liver recipients were observed. Then the clinical data of 18 normal DBD and their liver recipients were compared. Results After ECMO/CRRT, donor blood pressures rose and the doses of vasoactive agents decreased. Meanwhile urine volume also increased. Finally 4/5 livers could be transplanted. And 10 kidneys were transplanted successfully. There was no significant inter-group difference of liver function. Conclusions The applications of ECMO and CRRT improve liver function of donors with cardiopulmonary failure after brain death and boost the rates of organ donation and utilization. Key words: Extracorporeal membrane oxygenation; Continuous renal replacement therapy; Donation after brain death; Liver transplantation
体外膜氧合和持续肾替代治疗在脑死亡后心肺衰竭潜在器官供体器官维持中的应用
目的探讨体外膜氧合(ECMO)联合持续肾替代治疗(CRRT)对脑死亡后心肺衰竭潜在器官供体的作用,提高肝脏利用系数。方法对2015年7月至2017年5月5例脑死亡后心肺衰竭供者及其相应受者的临床资料进行分析。5例供体接受ECMO和CRRT治疗。相关数据包括接受治疗的供者血压、血管活性药物剂量、肝功能、肾功能和尿量的变化。同时观察肝受体的肝功能。然后比较18例正常DBD患者及其肝受体的临床资料。结果ECMO/CRRT后供者血压升高,血管活性药物剂量降低。同时尿量也有所增加。最终可移植4/5个肝脏。10例肾脏移植成功。各组间肝功能差异无统计学意义。结论ECMO和CRRT的应用改善了脑死亡后心肺衰竭供者的肝功能,提高了器官捐献率和利用率。关键词:体外膜氧合;持续肾替代治疗;脑死亡后捐赠;肝移植
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