脑死亡供体肝脏生理功能改变及维护措施的探讨

摘要

供体肝脏质量和功能是影响肝移植成功率和预后的重要因素.目前,国内外肝移植供肝主要来源于循环功能不稳定的脑死亡供体(DBD).机体脑死亡后,在短时间内即可诱发机体产生一系列严重的病理生理功能改变,引起机体血流动力学和内环境的改变,继而导致机体肝脏损伤,影响肝脏生理功能和质量,最终影响移植成功率和预后,甚至导致潜在供体器官的丢失.因而,针对脑死亡进程诱发的各种生理功能改变及其对肝脏造成的损伤,采取各种维护供体肝脏质量的措施,有效减轻器官损伤、改善器官功能和质量,最终提高器官利用率和移植成功率是十分有必要的.本文就脑死亡供体(DBD)的肝脏生理功能改变及维护措施展开综述.%The quality and function of the donor liver is one of the main factors which influence the success and prognosis of liver transplantation.At present,the major source of donor liver for transplantation is Donor of Brain Death (DBD) all over the world,which has unstable circulation.When the brain death occurs,a series of serious physiological function changes will be induced within a few minutes and affect the hemodynamics and homeostasis of the body,which will greatly influence the liver quality and function,and consequently the success and prognosis of liver transplantation,finally leading to the loss of potential donor organs.Therefore,it is necessary to identify the physiological function changes induced by the process of brain death and its injury to liver and take immediate proper protective measures,which can effectively reduce the organ injury,improve liver function and enhance the organ utilization and liver transplantation success.In this paper,the changes and maintenance measures of liver physiological function in DBD will be reviewed.