ABSTRACT
Neurogenic pulmonary edema (NPE) in brain dead organ donors occurring after an acute central nervous system insult threatens organ preservation of potential organ donors and the outcome of organ donation. Hence the active and immediate management of NPE is critical. In this case, a 50-year-old male was admitted to the intensive care unit (ICU) for organ donation. He was hypoxic due to NPE induced by spontaneous intracerebral hemorrhage and intraventricular hemorrhage. Protective ventilatory management, intermittent recruitment maneuvers, and supportive treatment were maintained in the ICU and the operating room (OR). Despite this management, the hypoxemia worsened after the OR admission. So inhaled nitric oxide (NO) therapy was performed during the operation, and the hypoxic phenomena showed remarkable improvement. The organ retrieval was successfully completed. Therefore, NO inhalation can be helpful in the improvement of hypoxemia caused by NPE in brain dead organ donors during anesthesia for the organ donation.
Subject(s)
Humans , Male , Middle Aged , Anesthesia , Hypoxia , Brain Death , Central Nervous System , Cerebral Hemorrhage , Hemorrhage , Inhalation , Intensive Care Units , Nitric Oxide , Operating Rooms , Organ Preservation , Pulmonary Edema , Tissue and Organ Harvesting , Tissue and Organ Procurement , Tissue DonorsABSTRACT
ObjectiveTo study the impact of allocation of organ arteries and their reconstruction for donor livers on arterial complications after liver transplantation from organ clusters obtained by combined liver,kidney,pancreas and duodenum harvesting.The aim is to guide future use of donor organs more safely and rationally with a decrease in postoperative complications.MethodWe studied 11 patients.ResultsThere was no hepatic artery anomaly.A Carrol artery patch was obtained at the bifurcation of the proper hepatic artery and the gastroduodenal artery in these donor livers.In one patient,an arterial graft was used because of inadequate arterial length,and arterial thrombosis developed which required re-transplantation.The hepatic arterial reconstruction was successful for the remaining 10 patients.One patient died of pulmonary infection 5 months post transplantation.ConclusionWhen combined liver,kidney,pancreas and duodenum harvesting was used,enough arterial length of the recipient must be preserved.There should be adequate and prompt communication between the teams carrying out the donor operation and the recipient operation.A Carrol arterial patch of the proper hepatic artery and the gastroduodenal artery for the donor liver,and the use of microsurgical vascular anastomosis in the operation are the keys to prevent hepatic arterial complications after liver transplantation.Multi-organ harvesting can be used for obtaining donor livers in liver transplantation.
ABSTRACT
Objective To evaluate clinical experience in kidneys alone or multiple organ retrieval (KMOR) from cadaver donors. Methods The data of 506 donors subjected to KMOR in our hospital from December 1988 to April 2003 were retrospectively analyzed. Results Among them, kidneys alone retrieval alone was done from 431 donors, kidney with livers from 55, kidney with pancreas from 10, and kidney with liver and heart from 10 donors. The surgical methods of KMOR were respectively introduced, and the advantages and the disadvantages of every method were clearly compared. Conclusion It should be especially emphasized that, a retrieval team, which is trained strictly to master proper techniques, and with good cooperation in work, is very important in successful organ harvest.