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extracorporeal membrane oxygenation; HIV; Pneumocystis jirovecii; respiratory failure.

Extracorporeal Membrane Oxygenation for the Support of a Potential Organ Donor with a Fatal Brain Injury before Brain Death Determination

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초록

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.

Abstract

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.

참고문헌 (12)

  1. Matas AJ, "2,500 living donor kidney transplants: a single-center experience", Ann Surg, 234, pp.149~164 (2001)
  2. Magliocca JF, "Extracorporeal support for organ donation after cardiac death effectively expands the donor pool", J Trauma, 58, pp.1095~1101 (2005)
  3. Salim A, "Aggressive organ donor management significantly increases the number of organs available for transplantation", J Trauma, 58, pp.991~994 (2005)
  4. Ke HY, "Increase the donor pool: transportation of a patient with fatal head injury supported with extracorporeal membrane oxygenation", J Trauma, 68, pp.E87~E88 (2010)
  5. Hsieh CE, "Extracorporeal membrane oxygenation support in potential organ donors for brain death determination", Transplant Proc, 43, pp.2495~2498 (2011)
  6. "Annual data report"[URL]
  7. Englesbe MJ, "Salvage of an unstable brain dead donor with prompt extracorporeal support", Transplantation, 79, pp.378~ (2005)
  8. Barrou B, "The use of extracorporeal membranous oxygenation in donors after cardiac death", Curr Opin Organ Transplant, 18, pp.148~153 (2013)
  9. 이종훈, "Kidney Transplantation from a Donor Following Cardiac Death Supported with Extracorporeal Membrane Oxygenation", Journal of Korean Medical Science, 27(2), pp.115~119 (2012), 대한의학회
  10. 이현, "The Use of Extracorporeal Circulation in Suspected Brain Dead Organ Donors with Cardiopulmonary Collapse", Journal of Korean Medical Science, 30(12), pp.1911~1914 (2015), 대한의학회
  11. 양정훈, "Use of Extracorporeal Membrane Oxygenation for Optimal Organ Donation", The Korean Journal of Critical Care Medicine, 29(3), pp.194~196 (2014), 대한중환자의학회
  12. Saucha W, "Apnea test in the determination of brain death in patients treated with extracorporeal membrane oxygenation (ECMO)", Anaesthesiol Intensive Ther, 47, pp.368~371 (2015)

관련 논문AI추천

Use of Extracorporeal Membrane Oxygenation for Optimal Organ Donation박치민, 서지영, 양정훈, 전경만, 정치량, 조양현대한중환자의학회 · Acute and Critical Care2014 · 제29권 제3호Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome following HAART Initiation in an HIV-infected Patient Being Treated for Severe Pneumocystis jirovecii Pneumonia: Case Report and Literature Review김봉영, 김상헌, 문지용, 박동원, 배현주, 손장원, 신동호, 윤호주, 이지영, 임대현대한중환자의학회 · Acute and Critical Care2016 · 제31권 제2호Recovery from Acute Respiratory Distress Syndrome with Long-Run Extracorporeal Membrane Oxygenation전진, 고윤석, 임채만, 허진원, 홍상범대한중환자의학회 · Acute and Critical Care2014 · 제29권 제3호Successful Management of Potential Non-Heart-Beating Donor with Extracorporeal Membrane Oxygenation -A Case Report-Gui Yun Sohn, Kyu Hyouck Kyoung, Suk-Kyung Hong, Yooun Joong Jung, Young Hwan Kim대한중환자의학회 · Acute and Critical Care2012 · 제27권 제4호One Hundred Seven Days of ECMO as a Bridge to Lung Transplantation: The Longest Duration Among Elderly Patients고신옥, 김명화, 김은정, 나성원, 박무석, 백효채, 이유진대한중환자의학회 · Acute and Critical Care2014 · 제29권 제1호Dual Extracorporeal Membrane Oxygenation Support for Bridging Lung Transplantation in Acute Exacerbation of Idiopathic Pulmonary Fibrosis김동중, 김준성, 박상헌, 이연주, 조영재대한중환자의학회 · Acute and Critical Care2014 · 제29권 제3호

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