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Use of Extracorporeal Membrane Oxygenation for Optimal Organ Donation

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초록

We report a case of extracorporeal membrane oxygenation (ECMO) support for donor organ preservation in a brain-dead patient following out-of-hospital cardiac arrest. A 43-year-old male patient was referred to the emergency department after an out-of-hospital cardiac arrest caused by ventricular fibrillation. Spontaneous circulation was restored after 8 minutes of cardiopulmonary resuscitation. ECMO was implemented because of hemodynamic deterioration. The patient then underwent coronary angiography and was implanted with a drug-eluting stent because of occlusion at the proximal portion of the right coronary artery. After 144 hours, brain death was established, and ECMO support for optimal oxygen delivery was sustained until organ retrieval after consent for donation was received from the family. Liver and kidneys were successfully transplanted to three recipients, respectively.

Abstract

We report a case of extracorporeal membrane oxygenation (ECMO) support for donor organ preservation in a brain-dead patient following out-of-hospital cardiac arrest. A 43-year-old male patient was referred to the emergency department after an out-of-hospital cardiac arrest caused by ventricular fibrillation. Spontaneous circulation was restored after 8 minutes of cardiopulmonary resuscitation. ECMO was implemented because of hemodynamic deterioration. The patient then underwent coronary angiography and was implanted with a drug-eluting stent because of occlusion at the proximal portion of the right coronary artery. After 144 hours, brain death was established, and ECMO support for optimal oxygen delivery was sustained until organ retrieval after consent for donation was received from the family. Liver and kidneys were successfully transplanted to three recipients, respectively.

참고문헌 (10)

  1. Lee CY, "Expanding the donor pool: use of renal transplants from non-heart-beating donors supported with extracorporeal membrane oxygenation", Clin Transplant, 19, pp.383~390 (2005)
  2. 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
  3. Lemiale V, "Intensive care unit mortality after cardiac arrest: the relative contribution of shock and brain injury in a large cohort", Intensive Care Med, 39, pp.1972~1980 (2013)
  4. Salim A, "The effect of a protocol of aggressive donor management: Implications for the national organ donor shortage", J Trauma, 61, pp.429~433 (2006)
  5. Isnardi DI, "Extracorporeal membrane oxygenation as a bridge to organ donation: a case report", Transplant Proc, 45, pp.2619~2620 (2013)
  6. Fukushima N, "Effects of exogenous adrenaline on the number of the beta-adrenergic receptors after brain death in humans", Transplant Proc, 34, pp.2571~2574 (2002)
  7. Yang HY, "Experience of heart transplantation from hemodynamically unstable braindead donors with extracorporeal support", Clin Transplant, 26, pp.792~796 (2012)
  8. Barrou B, "The use of extracorporeal membranous oxygenation in donors after cardiac death", Curr Opin Organ Transplant, 18, pp.148~153 (2013)
  9. Hsieh CE, "Extracorporeal membrane oxygenation support in potential organ donors for brain death determination", Transplant Proc, 43, pp.2495~2498 (2011)
  10. Wang CC, "Liver transplantation from an uncontrolled non-heart-beating donor maintained on extracorporeal membrane oxygenation", Transplant Proc, 37, pp.4331~4333 (2005)

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