Korean J Crit Care Med.  2012 Nov;27(4):279-282. 10.4266/kjccm.2012.27.4.279.

Successful Management of Potential Non-Heart-Beating Donor with Extracorporeal Membrane Oxygenation: A Case Report

Affiliations
  • 1Division of Trauma and Surgical Critical Care, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. skhong94@amc.seoul.kr
  • 2Department of Nursing, Asan Medical Center, Seoul, Korea.
  • 3Department of Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Abstract

Hemodynamics of a brain-dead donor can change rapidly during management. It frequently leads to loss of the donor or deterioration of organ functions. Various efforts have been made not to lose potential donors. Extracorporeal membrane oxygenation (ECMO) and non-heart-beating donation (NHBD) are good examples of such efforts. A 47 year-old woman with a history of hypertension, diabetes mellitus and atrial fibrillation was diagnosed with cerebral infarction and hemorrhage. Cardiopulmonary resuscitation was performed three times before transfer to our hospital. Her family agreed to organ donation. ECMO was applied due to her unstable vital signs, which made the first declaration of brain death possible. However, considering the deteriorating vital signs and expected cardiac arrest, it was decided to switch to NHBD under the family's consent. All life-support devices including ECMO were turned off in the operation room. After cardiac death was declared, the harvesting of liver and kidneys was performed with perfusion through an ECMO catheter. The liver and kidneys were successfully transplanted to three recipients.

Keyword

brain-dead donor; brain death; extracorporeal membrane oxygenation; non-heart-beating donation

MeSH Terms

Atrial Fibrillation
Brain Death
Cardiopulmonary Resuscitation
Catheters
Cerebral Infarction
Death
Diabetes Mellitus
Extracorporeal Membrane Oxygenation
Female
Heart Arrest
Hemodynamics
Hemorrhage
Humans
Hypertension
Kidney
Liver
Membranes
Perfusion
Tissue and Organ Procurement
Tissue Donors
Transplants
Vital Signs
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