心脏死亡后的捐赠——从那时到现在

Q4 Medicine
Robert M. Langer
{"title":"心脏死亡后的捐赠——从那时到现在","authors":"Robert M. Langer","doi":"10.1016/j.tpr.2022.100119","DOIUrl":null,"url":null,"abstract":"<div><p>At the early days of organ transplantation before the diagnosis of brain death came in use only organs of non-heart-beating persons - who were the first donors after cardiac death (DCD) - could be taken for organ transplantation beside the living donors.</p><p>Organs from the first brain-dead donor were transplanted in 1963 in Belgium, five years later the famous Harvard Committee criteria were published. Following that in the Western world DCD was not used for organ transplantation, just in exceptional cases for several decades.</p><p>However, organ scarceness lead the way back to the idea of DCD. The original Maastricht classification discerns uncontrolled and controlled DCD in 4 categories from dead upon arrival through unsuccessful resuscitation attempt and awaiting cardiac death to cardiac arrest of a brain-dead person.</p><p>The time between the cessation of the of the circulation and the perfusion of the organ with the specific storage fluid is crucial for the possible use of the organs as transplants.</p><p>The recent studies explore the possibilities of the reconditioning of the organs to allow more and more of them to use for transplantation. The applicability is mostly needed in DCD cases. It is still open whether cold or warm perfusion, static or machine perfusion in continuous or pulsatile form would be the best for which organ.</p><p>Despite the evidence of the usefulness of this donor category, DCD is still not used universally. For example in Europe only one-third of the countries use DCD, the main reason is the underdevelopment of the infrastructural criteria in some of the countries, and the unsolved ethical and organizational challenges in others.</p></div>","PeriodicalId":37786,"journal":{"name":"Transplantation Reports","volume":"8 1","pages":"Article 100119"},"PeriodicalIF":0.0000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":"{\"title\":\"Donation after cardiac death - From then to now\",\"authors\":\"Robert M. Langer\",\"doi\":\"10.1016/j.tpr.2022.100119\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>At the early days of organ transplantation before the diagnosis of brain death came in use only organs of non-heart-beating persons - who were the first donors after cardiac death (DCD) - could be taken for organ transplantation beside the living donors.</p><p>Organs from the first brain-dead donor were transplanted in 1963 in Belgium, five years later the famous Harvard Committee criteria were published. Following that in the Western world DCD was not used for organ transplantation, just in exceptional cases for several decades.</p><p>However, organ scarceness lead the way back to the idea of DCD. The original Maastricht classification discerns uncontrolled and controlled DCD in 4 categories from dead upon arrival through unsuccessful resuscitation attempt and awaiting cardiac death to cardiac arrest of a brain-dead person.</p><p>The time between the cessation of the of the circulation and the perfusion of the organ with the specific storage fluid is crucial for the possible use of the organs as transplants.</p><p>The recent studies explore the possibilities of the reconditioning of the organs to allow more and more of them to use for transplantation. The applicability is mostly needed in DCD cases. It is still open whether cold or warm perfusion, static or machine perfusion in continuous or pulsatile form would be the best for which organ.</p><p>Despite the evidence of the usefulness of this donor category, DCD is still not used universally. For example in Europe only one-third of the countries use DCD, the main reason is the underdevelopment of the infrastructural criteria in some of the countries, and the unsolved ethical and organizational challenges in others.</p></div>\",\"PeriodicalId\":37786,\"journal\":{\"name\":\"Transplantation Reports\",\"volume\":\"8 1\",\"pages\":\"Article 100119\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2451959622000270\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2451959622000270","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 2

摘要

在器官移植的早期阶段,在脑死亡的诊断开始使用之前,只有心脏死亡后的第一批供体,即不跳动的人的器官,才能在活体供体旁边进行器官移植。1963年,第一个脑死亡捐赠者的器官在比利时被移植,五年后,著名的哈佛委员会标准公布了。在那之后的几十年里,在西方世界,DCD并没有被用于器官移植,只是在一些特殊的情况下才被使用。然而,器官稀缺导致了DCD的出现。最初的马斯特里赫特分类法将不受控制和受控制的DCD分为4类,从到达时死亡,通过不成功的复苏尝试和等待心源性死亡到脑死亡的心脏骤停。循环停止和器官灌注特定储存液之间的时间对于器官用作移植的可能性至关重要。最近的研究探索了器官修复的可能性,以允许越来越多的器官用于移植。该方法的适用性主要应用于DCD案例。无论是冷灌注还是热灌注,静态灌注还是连续或搏动形式的机器灌注对哪个器官最好,仍然是开放的。尽管有证据表明这一捐助者类别是有用的,但DCD仍然没有得到普遍使用。例如,在欧洲,只有三分之一的国家使用DCD,主要原因是一些国家的基础设施标准不发达,以及其他国家未解决的伦理和组织挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Donation after cardiac death - From then to now

At the early days of organ transplantation before the diagnosis of brain death came in use only organs of non-heart-beating persons - who were the first donors after cardiac death (DCD) - could be taken for organ transplantation beside the living donors.

Organs from the first brain-dead donor were transplanted in 1963 in Belgium, five years later the famous Harvard Committee criteria were published. Following that in the Western world DCD was not used for organ transplantation, just in exceptional cases for several decades.

However, organ scarceness lead the way back to the idea of DCD. The original Maastricht classification discerns uncontrolled and controlled DCD in 4 categories from dead upon arrival through unsuccessful resuscitation attempt and awaiting cardiac death to cardiac arrest of a brain-dead person.

The time between the cessation of the of the circulation and the perfusion of the organ with the specific storage fluid is crucial for the possible use of the organs as transplants.

The recent studies explore the possibilities of the reconditioning of the organs to allow more and more of them to use for transplantation. The applicability is mostly needed in DCD cases. It is still open whether cold or warm perfusion, static or machine perfusion in continuous or pulsatile form would be the best for which organ.

Despite the evidence of the usefulness of this donor category, DCD is still not used universally. For example in Europe only one-third of the countries use DCD, the main reason is the underdevelopment of the infrastructural criteria in some of the countries, and the unsolved ethical and organizational challenges in others.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Transplantation Reports
Transplantation Reports Medicine-Transplantation
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
101 days
期刊介绍: To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信