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：13只Beagle犬经静脉给予前列环素、维拉帕米、普萘洛尔和萘莫司他后，用泮溴铵窒息，停止呼吸支持。在将器官留在尸体中30分钟后，用PCPS再灌注尸体1小时，预充液包括上述4种药物和KCl。心脏Tx（HTx）：8例心脏在UW液中保存24 h后，用终末去白细胞含血停搏液原位移植。单肺移植（LTx）：5例左肺原位移植。肾脏治疗（RTx）：结果：供心均在窒息后20分钟内停止，无室颤。HTx：所有移植物均自发搏动，所有动物均在不使用儿茶酚胺的情况下脱离心肺转流。LTx：供肺肺静脉血氧分压和二氧化碳分压与受体肺（对照）无差异。RTx：所有移植肾在再灌注后均能迅速排尿，尿量均大于1 ml/Kg.结论：经四种药物预处理后，用PCPS复苏的无心跳供体心、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 : 13 beagle dogs 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 KCl. Heart Tx (HTx) : 8 heart was preserved in UW solution for 24 hours and transplanted orthotopically with using terminal leukocyte-depleted blood cardioplegia Single lung Tx (LTx) : 5 left lung were transplanted orthotopically. Renal Tx (RTx) : 3 kidneys were transplanted heterotopically in the groin.Results : All donor hearts stopped within 20 minutes after asphyxia without ventricular fibrillation. HTx : All grafts beated spontaneously and all animals was weaned from cardiopulmonary bypass without using catecholamine. LTx : The O2 pressure and CO2 pressure of pulmonary vein blood of donor lung were not different from those of the recipient (control) lung. All animals could survived until the lung was rejected.RTx : All transplanted kidney make urine soon after reperfusion with more than 1 ml/Kg of output.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.