Both family consent and legal consent were required for organ/tissue
donation from non-heart-beating donors (NHBD) in Taiwan.
取得家属与法律同意
(P.S. NHBD和现在各位键盘医师认定的移植条件不是同一群人,
这些人是不用判脑死的)
A district attorney had to come to the bedside to confirm the donor's asystole,
confirm the family consent, and complete some legal documents before a legal
consent was issued for organ donation.
要等到检察官到场确认患者已无心跳,有家属同意与相关法律文件
The resultant warm ischemic time would be unpredictably long and in fact
precluded the organ donation from NHBD in Taiwan.
在台湾这些无谓的时间浪费是难以预测的久, 而且阻碍了部份器官移植的可能
We developed a method of using extracorporeal membrane oxygenation (ECMO)
to maintain NHBD for a longer time and prevent warm ischemic injury of the
donor abdominal organs.
因此,我们发展出一个方法,在这个等待期能防止器官衰败
After ventilator disconnection in NHBD, phentolamine and heparin were
injected and mannitol infusion was given.
拔掉呼吸器后,打phentolamine, heparine, mannitol
After the donor's asystole was confirmed by the electrocardiogram (EKG)
strip recording, the ECMO support was set up through the right femoral
veno-arterial route,
由心电图确认捐赠者已无心跳,开始放置ECMO
an occlusion balloon catheter was inserted through the left femoral artery
to occlude the thoracic aorta, and bilateral femoral arteries were ligated.
放入一个阻隔气球到左股动脉(左下肢最大动脉), 完全阻挡胸主动脉的血,并将双侧
股动脉的结扎掉(指远端)
(P.S. 前几篇有键盘医师回说这是IABP用来保护心脏的, 我快笑死了,
想回打脸文之前,连柯医师的paper都不看,你们也认真点好吗?)
Usually, the ECMO could begin within 10 min after the donor's asystole.
通常我们只需10分钟可搞定
The ECMO, combined with a cooler, provided cold oxygenated blood to the
abdominal visceral organs,and prevented their warm ischemic injuries.
Under the ECMO support (range: 45-70 min), eight renal grafts were procured
from 4 NHBD.
点点点ECMO的好处
With the exception of the first two renal grafts with delayed function, all
others had immediate function postoperatively and dialysis was no
longer needed.
我们这个方法在器官移植成功上的介绍
In conclusion, by our ECMO technique, NHBD could be maintained for a longer
time and the renal grafts had better immediate postoperative function than
those reported by other methods.
结论, 使用ECMO可以在 NHBD患者上维持器官新鲜度更久.