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Трансплантология

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ВЕДЕНИЕ ПОТЕНЦИАЛЬНОГО ДОНОРА СО СМЕРТЬЮ МОЗГА (ЧАСТЬ 1)

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Аннотация

Основным фактором, ограничивающим трансплантацию, является недостаток донорских органов. В настоящее время большинство трансплантаций производится от доноров со смертью мозга (СМ). Со смертью в большинстве случаев связана выраженная физиологическая нестабильность, которая может привести или к ухудшению функции донорского органа до эксцизии, или к потере донора. При активном или даже агрессивном ведении донора возможны управление и коррекция патофизиологических процессов в донорских органах, тем самым увеличивается число и улучшается функциональное состояние донорских органов.

Агрессивная стратегия ведения потенциальных доноров со СМ требует изменения не только в подходах к интенсивной терапии, но и философии в оценке проводимой работы. Несмотря на разработку и внедрение различных протоколов ведения доноров со СМ, оптимального сочетания целей, мониторинга, специфической терапии до настоящего момента пока не достигнуто.

Об авторе

В. Л. Виноградов
ГБУЗ «НИИ скорой помощи им. Н.В. Склифосовского ДЗМ»
Россия


Список литературы

1. Rahmel А., ed. Annual Report. Eurotransplant International Foundation 2013. Leiden: Eurotransplant Foundation. 2013. 156 p. Available at: http://www.eurotransplant.org/cms/mediaobject.php?file=AR20135.pdf

2. Klein A., Messersmith E., Ratner L., et al. Organ donation and utilization in the United States, 1999–2008. Am. J. Transplant. 2010; 10 (4): Pt. 2. 973–986.

3. Organ donation and transplantation. Activity report 2013/14. Available at: http://www.organdonation.nhs.uk/statistics/transplant_activity_report/current_activity_reports/ukt/activity_report_2013_14.pdf

4. Got'e S.V., Moysyuk Ya.G., Khomyakov S.M. Donorstvo i transplantatsiya organov v Rossiyskoy Federatsii v 2013 godu. VI soobshchenie registra rossiyskogo transplantologicheskogo obshchestva [Organ donation and transplantation in the Russian Federation in 2013. VI Post Register Transplantological Russian society]. Vestnik transplantologii I iskusstvennykh organov. 2014; 2: 5–23.(In Russian).

5. Manara A.R., Murphy P.G., O’Callaghan G. Donation after circulatory death. BJA.2012; 108 (1): i108–i121.

6. Posmertnoe donorstvo. Natsional'nye klinicheskie rekomendatsii [Posthumous donation. National clinical guidelines]. Moscow, 2013. Available at: http://transpl.ru/images/cms/data/pdf/ nacional_nye_klinicheskie_rekomendacii_posmertnoe_donorstvo_organov.pdf (In Russian).

7. Matesanz R., Dominguez-Gil B. Strategies to optimize deceased organ donation.Transplantation Reviews. 2007; 21: 177–188.

8. Mackersie R, Bronsther O., Shackford S. Organ procurement in patients with fatal head injuries. The fate of the potential donor. Ann. Surg. 1991; 213: 143–150.

9. Hennessy S.A., Hranjec T., Swenson B.R., et al. Donor factors are associated with bronchiolitis obliterans syndrome after lung transplantation. Ann. Thorac.Surg. 2010; 89: 1555–1562.

10. Stehlik J., Feldman D.S., Brown R.N., et al. Interactions among donor characteristics influence post-transplant survival: a multiinstitutional analysis. J. Heart Lung. Transplant. 2010; 29: 291–298.

11. Alamo J.M., Barrera L., Marı´n L-M., et al. Results of liver transplantation with donors older than 70 years: a case–control study. Transplant. Proc. 2011; 43:2227–2229.

12. Feng S., Goodrich N.P., Bragg-Gresham J.L., et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am. J. Transplant.2006; 6: 783–790.

13. Nafidi O., Marleau D., Roy A., Bilodeau M. Identification of new donorvariables associated with graft survival in a single-center liver transplant cohort. Liver Transpl. 2010; 16: 1393–1399.

14. Esmaeilzadeh M., Dictus C., Kayvanpour E., et al. One life ends, another begins: management of a brain-dead pregnant mother – a systematic review.BMC Med. 2010; 8: 74 p.

15. Maruya J., Nishimaki K., Nakahata J., et al. Prolonged somatic survival of clinically brain-dead adult patient. Neurol. Med. Chir. 2008; 48: 114–117.

16. Stulin I.D., Patofiziologicheskie mekhanizmy smerti mozga. [Pathophysiological mechanisms of brain death]. In: Stulin I.D., ed. Diagnostika smerti mozga [Diagnosis of brain death]. Moscow: GEOTARMedia Publ., 2009. 42 p. (In Russian).

17. Cushing H. The blood-pressure reaction of acute cerebral compression, illustrated by cases of intracranial hemorrhage. A sequel to the Mutter lecture for 1901. Am. J. Med. Sci. 1903; 125: 1017–1044.

18. Cushing H. Some experimental and clinical observations concerning states of increased intracranial tension. Am. J. Med. Sci. 1902; 124: 375–400.

19. Venkateswaran R.V., Townend J.N., Wilson I.C., et al. Echocardiography in the potential heart donor. Transplantation. 2010; 89: 894–901.

20. Agrawal A., Timothy J., Cincu R. Bradycardia in neurosurgery. Clin. Neurol. Neurosurg. 2008; 110: 321–327.

21. Bugge J. Brain death and its implications for management of the potential organ donor. Acta. Anaesthesiol. Scand. 2009; 53: 1239–1250.

22. Smith M. Physiologic changes during brain stem death – lessons for management of the organ donor. J. Heart Lung. Transplant. 2004; 23 (9): 217–222.

23. Shivalkar B., Van Loon J., Wieland W., et al. Variable effects of explosive or gradual increase of intracranial pressure on myocardial structure and function. Circulation. 1993; 87: 230–239.

24. Szabỏ G., Hackert T., Sebening C., et al. Modulation of coronary perfusion pressure can reverse cardiac dysfunction after brain death. Ann. Thorac. Surg. 1999; 67: 18–25.

25. Tuttle-Newhall J.E., Collins B.H., Kuo P.C., Schoeder R. Organ donation and treatment of the multiorgan donor. Curr. Prob. Surg. 2003; 40: 253–310.

26. Novitzky D., Rhodin J., Cooper D.K.C. Ultrastructure changes associated with brain death in the human donor heart. Transpl. Int. 1997; 10: 24–32.

27. Dujardin K.S., McCully R.B., Wijdicks E.F., et al. Myocardial dysfunction associated with brain death: clinical, echocardiographic, and pathologic features. J. Heart Lung. Transplant. 2001; 20: 350–357.

28. Avlonitis V.S., Wigfield C.H., Kirby J.A., Dark J.H. The hemodynamic mechanisms of lung injury and systemic inflammatory response following brain death in the transplant donor. Am. J. Transplant. 2005; 5 (4): Pt 1. 684–693.

29. Novitzky D., Wicomb W., Rose A.G., et al. Pathophysiology of pulmonary edema following experimental brain death in the chacma baboon. Ann. Thorac. Surg. 1987; 43: 288–294.

30. Novitzky D., Cooper D.K.C., Rosendale J.D., Kauffman H.M. Hormonal therapy of the brain-dead organ donor: experimental and clinical studies. Transplantation. 2006; 82: 1396–1401.

31. Tien R.D. Sequence of enhancement of various portions of the pituitary gland on gadolinium-enhanced MR images: correlation with regional blood supply. Am. J. Roentgenol. 1992; 158: 651–654.

32. Gramm H.J., Meinhold H., Bickel U., et al. Acute endocrine failure after brain death? Transplantation. 1992; 54: 851–857.

33. Novitzky D., Cooper D.K.C., Wicomb W. Hormonal therapy to the brain-dead potential organ donor: the misnomer of the “Papworth Cocktail”. Transplantation.2008; 86: 1479.

34. Powner D.J., Hendrich A., Lagler R.G., et al. Hormonal changes in brain dead patients. Crit. Care Med. 1990; 18: 702–708.

35. Shemie S.D., Ross H., Pagliarello J., et al. Organ donor management in Canada: recommendations of the forum on medical management to optimize donor organ potential. CMAJ. 2006; 174: S13–S32.

36. Wood K.E., Becker B.N., McCartney J.G., et al. Care of the potential organ donor. N. Engl. J. Med. 2004; 351: 2730– 2739.

37. Barklin A., Larsson A., Vestergaard C., et al. Insulin alters cytokine contentin two pivotal organs after brain death: a porcine model. Acta. Anaesthesiol. Scand. 2008; 52: 628–634.

38. Talving P., Benfield R., Hadjizacharia P., et al.Coagulopathy in severe traumatic brain injury: a prospective study. J. Trauma. 2009; 66: 55–61.

39. Barklin A. Systemic inflammation in the brain-dead organ donor. Acta. Anaesthesiol. Scand. 2009; 53: 425–435.

40. Hefty T.R., Cotterell L.W., Fraser S.C., et al. Disseminated intravascular coagulation in cadaveric organ donors. Incidence and effect on renal transplantation. Transplantation. 1993; 55: 442–443.

41. Fisher A.J., Donnelly S.C., Hirani N., et al. Enhanced pulmonary inflammation in organ donors following fatal nontraumatic brain injury. Lancet. 1999; 353: 1412–1413.

42. McKeating E.G., Andrews P.J.D. Cytokines and adhesion molecules in acute brain injury. Br. J. Anaesth. 1998; 80: 77–84.

43. Pratschke J., Neuhaus P., Tullius S.G. What can be learned from brain-death models? Transpl. Int. 2005; 18: 15–21.

44. Venkataraman R., Song M., Lynas R., Kellum J.A. Hemoadsorption to Improve Organ Recovery from Brian-Dead Organ Donors: A Novel Therapy for a Novel Indication? Blood Purif. 2004; 22: 143– 149.

45. Mascia L., Mastromauro I., Viberti S., et al. Management to optimize organ procurement in brain dead donors. Minerva Anestesiol. 2009; 75: 125–133.

46. Srinivasan A., Burton E.C., Kuehnert M.J., et al. Transmission of rabies virus from an organ donor to four transplant recipients. N. Engl. J. Med. 2005; 352: 1103–1111.

47. Darby J.M., Stein K., Grenvik A., Stuart S.A. Approach to management of the heartbeating ‘brain dead’ organ donor. J. Am. Med. Assoc. 1989; 261: 2222–2228.

48. Wheeldon D.R., Potter C.D., Oduro A., et al. Transforming the ‘unacceptable’ donor: outcomes from the adoption of a standardized donor management technique.J. Heart Lung. Transplant. 1995; 14: 734–742.

49. Rosendale J.D., Kauffman H.M., McBride M.A., et al. Aggressive pharmacologic donor management results in more transplanted organs. Transplantation.2003; 75: 482–487.

50. UNOS. Critical Pathway for the Organ Donor. 2002. Available at: https:// www.unos.org/docs/Critical_Pathway. pdf

51. Rosendale J.D., Chabalewski F.L., McBride M.A., et al. Increased transplanted organs from the use of a standardized donor management protocol. Am. J. Transplant. 2002; 2: 761–768.

52. Salim A., Velmahos G.C., Brown C., et al. Aggressive organ donor management significantly increases the number of organs available for transplantation. J. Trauma. 2005; 58: P.991–994.


Для цитирования:


Виноградов В.Л. ВЕДЕНИЕ ПОТЕНЦИАЛЬНОГО ДОНОРА СО СМЕРТЬЮ МОЗГА (ЧАСТЬ 1). Трансплантология. 2014;(3):23-31.

For citation:


Vinogradov V.L. Management of a potential donor with brain death (PART 1). Transplantologiya. The Russian Journal of Transplantation. 2014;(3):23-31. (In Russ.)

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