In situ liver splitting under extracorporeal membrane oxygenation in brain-dead donor

被引：18

作者：

Assalino, Michela ^{[1
]}

Majno, Pietro ^{[1
,2
]}

Toso, Christian ^{[1
]}

Berney, Thierry ^{[1
]}

Giraud, Raphael ^{[3
]}

Dutkowski, Philipp ^{[4
]}

Andres, Axel ^{[1
]}

Wildhaber, Barbara ^{[5
]}

Elkrief, Laure ^{[1
]}

机构：

[1] Univ Hosp, Div Transplantat, Dept Surg, Geneva, Switzerland

[2] Univ Hosp Geneva, HPB Ctr, Geneva, Switzerland

[3] Intens Care Univ Hosp, Geneva, Switzerland

[4] Univ Hosp, Div Transplantat, Zurich, Switzerland

[5] Univ Hosp, Univ Ctr Pediat Surg Western Switzerland, Geneva, Switzerland

来源：

AMERICAN JOURNAL OF TRANSPLANTATION | 2018年 / 18卷 / 01期

关键词：

donors and donation: donation after brain death (DBD); donors and donation: extended criteria; extracorporeal membrane oxygenation (ECMO); liver transplantation/hepatology; liver transplantation: split; organ procurement; organ procurement and allocation; TRANSPLANTATION; ORGAN; EXPERIENCE; CRITERIA; SUPPORT;

D O I：

10.1111/ajt.14461

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Hemodynamic instability is generally considered as a contraindication to liver splitting, in particular when using an in situ technique. We describe the cases of two young donors with brain death in whom refractory cardiac arrest and hemodynamic instability were supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO), allowing uneventful in situ splitting. Two adult and two pediatric liver recipients were successfully transplanted with immediate graft function. Favorable outcomes were also observed for the other transplanted organs, including one heart, two lungs, and four kidneys. Refractory cardiac arrest and hemodynamic instability corrected by VA-ECMO should not be considered as a contraindication to in situ liver splitting.

引用

页码：258 / 261

页数：4

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