Organ Procurement Process for Organ Donation after Cardiac Death_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUO Feng ¹ , WANG Shaoping ¹ , LI Peng ¹ , ZHENG Yujian ¹ , PU Miaoshui ¹ , CHEN Jianxiong ¹ , ZHAN Shilin ¹ , HE Huan. ²

1. Department of Hepatobiliary Surgery and Liver Transplantation Center， Guangzhou General Hospital， Guangzhou Military Area， Guangzhou 510010， Guangdong Province， China;;
2. Department of Anesthesiology， Guangzhou General Hospital， Guangzhou Military Area， Guangzhou 510010， Guangdong Province， China;

Corresponding author：

Keywords：

Donation after cardiac death; Donation afer brain death plus cardiac death; Extracorporeal membrane oxygenation; Procurement process

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Objective 　To summarize and further investigate the initial experience of organ procurement process for organ donation after cardiac death （DCD）.
Methods 　The clinical data，the selected standard，and the organ procurement process of 28 cases of DCD from July 2009 to January 2012 in the liver transplantation center of Guangzhou General Hospital were reviewed and analyzed.
Results 　Twenty-eight cases of DCD all had donated organs successfully. Among these cases，there were 3 cases （10.7%） of the Maastricht Ⅲ， and one case （3.6%） of the Maastricht Ⅳ，and 24 cases （85.7%） of the organ donation after brain death plus cardiac death （DBCD）．Three cases of the Maastricht Ⅲ were practiced the organ procurement process of DCD．One case of the Maastricht Ⅳ was practiced the organ procurement process of DBCD without the extracorporeal membrane oxygenation （ECMO）．Twenty-four cases of DBCD were practiced the organ procurement process of DBCD with the ECMO．The donator warm ischemic time was zero min in DBCD，18 min in Maastricht Ⅳ，and mean 25 min （22-28 min） in MaastrichtⅢ．All the donated organs included 28 livers，40 kidneys，and 2 hearts．And all these organs had been practiced the liver transplantation，the kidney transplantation，and the heart transplantation.
Conclusions 　The organ procurement process for organ DCD includes the DCD process and the DBCD process in China，and the later includes the organ procurement process with the ECMO and without the ECMO．The ECMO could well control the warm ischemia for protecting the donors just without ethics dispute. So，the using of the ECMO for the organ DCD of citizen in China has a very important contribution．

Citation： HUO Feng,WANG Shaoping,LI Peng,ZHENG Yujian,PU Miaoshui,CHEN Jianxiong,ZHAN Shilin,HE Huan.. Organ Procurement Process for Organ Donation after Cardiac Death. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(5): 468-472. doi: Copy

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1. 脑死亡判定标准( 成人) ( 征求意见稿) [J]. 中华急诊医学杂志，2003， 12(2)：142-144.
2. 卫生部脑死亡判定标准起草小组. 脑死亡判定标准( 成人) ( 修订稿) [J]. 中国脑血管病杂志， 2009， 6(4)：220-224.
3. Lewis J， Peltier J， Nelson H， et al. Development of the University of Wisconsin donation after cardiac death evaluation tool [J].Prog Transplant， 2003， 13(4)：265-273.
4. Kootstra G， Daemen JH， Oomen AP. Categories of non-heartbeating donors [J]. Transplant Proc， 1995， 27(5)：2893-2894.
5. 中华人民共和国卫生部医疗服务监管司. 卫生部办公厅关于启动心脏死亡捐献器官移植试点工作的通知( 附件1 －中国心脏死亡器官捐献分类标准. doc)[EB/OL]. http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/s9968/201104/51516.htm.
6. Casavilla A， Ramirez C， Shapiro R， et al. Experience with liver and kidney allografts from non-heart-beating donors [J]. Transplant Proc， 1995， 27(5)：2898.
7. Moers C， Leuvenink HG， Ploeg RJ. Donation after cardiac death：evaluation of revisiting an important donor source [J].Nephrol Dial Transplant， 2010， 25(3)：666-673.
8. Chaib E， Massad E. The potential impact of using donations after cardiac death on the liver transplantation program and waiting list in the state of Sao Paulo， Brazil [J]. Liver Transpl， 2008，14(12)：1732-1736.
9. UNOS. Critical pathway for donation after cardiac death[EB/OL].http://www.unos.org/docs/Critical_Pathway_DCD_Donor.pdf.
10. Shemie SD， Baker AJ， Knoll G， et al. National recommendations for donation after cardiocirculatory death in Canada：Donation after cardiocirculatory death in Canada[J]. CMAJ， 2006，175(8)：S1.
11. Australian Organ and Tissue Donation and Transplantation Authority.National Protocol for Donation after Cardiac Death EB/OL].http://www.health.gov.au/internet/budget/publishing.nsf/Content/2009-2010_Health_PBS_sup3/$File/Australian%20 Organ%20and%20Tissue%20Donation%20and%20Transplantation% 20Authority.pdf.
12. Reich DJ， Mulligan DC， Abt PL， et al. ASTS recommended practice guidelines for controlled donation after cardiac death organ procurement and transplantation [J]. Am J Transplant，2009， 9(9)：2004-2011.
13. Shemie SD， Hornby K. Donor organ management：survey of guidelines and eligibility criteria [EB/OL]. http://www.organsandtissues.ca/s/wp-content/uploads/2011/11/Organ-Donor-Guidelines.pdf.
14. Bernat JL，D’Alessandro AM， Port FK， et al. Report of a National conference on donation after cardiac death [J]. Am J Transplant， 2006， 6(2)：281-291.
15. Devita MA， Brooks MM， Zawistowski C，et al. Donors after cardiac death：validation of identification criteria (DVIC) study for predictors of rapid death [J]. Am J Transplant， 2008， 8(2)：432-441.
16. 霍枫，汪邵平，李鹏，等. 公民心死亡器官捐献肝移植 [J].中华消化外科杂志， 2012， 11(1)：69-75.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Organ Procurement Process for Organ Donation after Cardiac Death

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