探讨心脏死亡器官捐献（DCD）中供者评估和器官功能维护的方法及效果。

回顾性分析2015年1月至2019年5月广东省韶关市翁源县人民医院进行DCD器官捐赠的47例供者临床资料。其中男35例，女12例；年龄19～64岁，中位年龄35岁。供者或其家属均签署患者知情同意书，符合医学伦理学规定。对供者全身状况严格充分评估，使用辅助控制通气维持呼吸功能稳定，维持循环功能和内环境稳定。采用经腹主动脉和门静脉联合灌注及多器官联合切取方式获取供肝和供肾。器官采用静态冷冻保存法保存。观察供者器官维护和利用情况。

23例伴高钠血症供者采用持续血液透析，5例血流动力学不稳定应用大剂量升压药物维持血压。2例因术前Scr水平较高行持续性肾替代治疗。42例使用过至少一种血管活性药物。47例DCD供者均成功实施器官捐献，共获取47个肝脏和94个肾脏，并成功用于肝移植44例（弃用3例），肾移植92例（弃用1例共2个肾脏）。移植后的肝脏及肾脏功能恢复良好，未发生原发性移植物无功能。

充分评估DCD供者全身情况，采取有效的器官功能维护，使多器官供者生理状况处于最佳平衡状态，有利于提高器官捐献率和器官质量。

To explore the measures and effect of donor assessment and maintenance of organ function in donation after cardiac death (DCD).

Clinical data of 47 DCD donors from January 2015 to June 2019 in the People's Hospital of Wengyuan County, Shaoguan, Guangdong, were retrospectively analyzed. There were 35 male and 12 female donors, aged 19-64 years, with a median of 35 years. The informed consent of donors or their family were obtained and the local ethical committee approval was received. The donors were critically and adequately assessed for general condition, and assist-control ventilation was used to maintain stable respiratory and circulatory function and homoiostasis were maintained. The donating liver and kidney were harvested by combined perfusion through transabdominal aortic and portal vein and total abdominal evisceration. Grafts were preserved by static freezing. The maintenance and use of donating organs were observed.

Continuous hemodialysis was performed in 23 cases with hyponatremia, and high doses of vasopressors were used to maintain blood pressure in 5 cases with hemodynamic instability. Continuous renal replacement therapy was performed in 2 cases due to high preoperative Scr level. 42 cases had medication history of at least one vasoactive drug. All the 47 DCD donors underwent successful organ donation and 47 livers and 94 kidneys were harvested. 44 successful liver transplantations (3 liver grafts were abandoned) and 92 successful renal transplantations (2 kidney grafts of 1 case were abandoned) were reported. Hepatic and renal function restored well after transplantation, and no primary graft failure was observed.

Adequate assessment of the general condition of DCD donors, application of effective measures to maintain organ function and keep optimal physiological balance of the donors contributes to improved organ donation rates and organ quality.