ABSTRACT
Objective:To investigate the ethical significance of the extracorporeal circulation membrane oxy-genation ( ECMO) in the donation organ transplantation .Methods: Analyzing the data of ECMO protected to the organ in 13 donors after brain death , Accounting the rising costs which caused by ECMO and make the interview to the patients and family members .Results:In the period of ECMO flow , the hemodynamic of the DBD donors be-come stable gradually , the medications reduced significantly or stop , the function of organs was restored .There were 38 organs can be used for the transplantation which were proven by the pathological biopsy .Twenty six kid-neys were transplanted to 26 recipients and liver transplantation was performed in 12 recipients.All transplantations were successfully completed .Medical cost of this patients increase 5.3%, all of the family members and patients can accept the intervention of ECMO .Conclusion:ECMO is an effective method to protect and improve the utili-zation rate of the organ .the improvement of the related technical standards , legal, laws and ethics of staff will pro-mote to the development of organ transplantation .
ABSTRACT
Objective To analyze the common causes leading to lung infection following renal transplantation and provide targeted preventive measures to reduce the incidence of lung infection.Methods The clinical data of 561 recipients who underwent renal transplantation from January 2006 to February 2011 were retrospectively analyzed.The recipients were divided into two groups:group Ⅰ,from January 2006 to December 2009 (n =416) ; group Ⅱ,from January 2010 to February 2011 (n =145).The causes possibly leading to lung infection which took place 3 days before the appearance of the clinical symptoms were offered by the patients who suffered lung infection of group Ⅰ.And then the causes were summarized and analyzed to formulate the specific and comprehensive measures to prevent the infection.Finally the measures were applied to recipients in group Ⅱ from January 2010.After applying the measures for 14 months,the incidence of lung infection in group Ⅱ was counted and compared with that in group Ⅰ to see the preventive effect.Results There were 58 cases of lung infection in group Ⅰ (58/416,13.9％) and 12 cases in group Ⅱ (12/145,8.3％). There was significant difference in the incidence of lung infection between two groups (x2 =4.0361,P＜0.05).All of the recipients with lung infection were hospitalized in six months after the transplantation.The causes leading to lung infection of 58 cases in group Ⅰ were as follows:6 cases due to being excessively tired,3 cases due to guest visiting,12 cases due to abrupt change of weather,9 cases due to exposure to public place,8 cases due to returning to hospital,6 cases due to close contact with children,5 cases due to close contact with animals,and the other 9 cases without specific causes found.Conclusion The incidence of lung infection following renal transplantation can be notably reduced by the application of targeted and concrete health propaganda education and preventive measures based on analysis on the specific causes of infection.
ABSTRACT
Objective 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.