ESTABLISHMENT OF MULTIORGAN PROCUREMENT SYSTEM FROM NO-HEART-BEATING DONOR USING PERCUTANEOUS CARDIOPULMONARY BYPASS

供体短缺是器官移植中最严重的问题之一。使用无心跳供体可能会极大地扩大供体库。方法：3只猪，经静脉给予前列环素、维拉帕米、心得安和萘莫司他，用潘可溴铵窒息，停止呼吸支持，观察经皮心肺支持（PCPS）对无心跳供体多器官复苏的效果。在将器官留在尸体中30分钟后，用包括上述四种药物和KCl的预充液通过PCPS对尸体再灌注1小时。心脏Tx（HTx）：3例心脏在改良柯林斯液中保存24 h后，采用终末去白细胞血停搏法原位移植。结论：经四种药物预处理后，再用PCPS复苏的无心跳供体的心、肺、肾均可成功移植，该方法可扩大供体库。

Donor shortage is one of the most serious problem in organ transplantation (Tx). Use of non-heart-beating donors may extremely expand donor pools. In this study, the method of reanimation of multiple organs in non-heart-beating donor by percutaneous cardiopulmonary support (PCPS) was evaluated.Methods : 3 pigs were asphyxiated with pancronium bromide and cessation of respiratory support after giving prostacyclin, verapamil, propranolol and nafmostat mesilate, intravenously. After leaving organs for 30 minutes in the dead body, the body was reperfused by PCPS for 1 hour with the priming fluid including four drugs shown above and KC1. Heart Tx (HTx): 3 heart was preserved in Modified Collins solution for 24 hours and transplanted orthotopically with using terminal leukocyte-depleted blood cardioplegiaResults : All donor hearts stopped within 20 minutes after asphyxia without ventricular fibrillation. All grafts beated spontaneously and all animals was weaned from cardiopulmonary bypass without using catecholamine, however all pigs died of respiratory disorder.Conclusions : These data suggested that hearts, lungs and kidneys from non-heart-beating donor which were pretreated with four drugs and reanimated with PCPS be transplanted successfully and that this method may expand donor pool.