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Korean J Crit Care Med > Volume 27(4); 2012 > Article
Korean Journal of Critical Care Medicine 2012;27(4): 279-282. doi: https://doi.org/10.4266/kjccm.2012.27.4.279
Successful Management of Potential Non-Heart-Beating Donor with Extracorporeal Membrane Oxygenation: A Case Report
Young Hwan Kim, Gui Yun Sohn, Yooun Joong Jung, Kyu Hyouck Kyoung, Suk Kyung Hong
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.
Key Words: brain-dead donor; brain death; extracorporeal membrane oxygenation; non-heart-beating donation
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