总结公民逝世后合并全身感染供者的实体器官捐献初步经验。

回顾性分析2015年1月至2019年5月广东省翁源县人民医院收治的47例公民逝世后心脏死亡器官捐献供者临床资料。供受者和（或）家属均签署知情同意书，符合医学伦理学规定。其中男38例，女9例；平均年龄（29±14）岁。分析供者外周静脉血（PVB）、中心静脉血（BCVC）、中心静脉导管头端（TCVC）、支气管冲洗液、尿液的细菌培养结果。

47例供者ICU治疗时间为1～35 d，中位时间10 d。供者PVB、BCVC、TCVC、支气管抽吸物及尿液的细菌培养阳性率分别为6%（3/47）、4%（2/47）、6%（3/47）、17%（8/47）、4%（2/47）。PVB阳性供者革兰氏阳性菌感染1例，革兰氏阴性菌感染2例，其中1例分离出念珠菌。供者尿液分离出念珠菌3例，大肠杆菌2例。肝移植受者根据PVB细菌药物敏感（药敏）试验接受相应的抗生素治疗，而肾移植受者则根据PVB和尿液的细菌药敏试验进行相应的抗生素治疗，其他阴性受者经验用药。共获取了47个肝脏和94个肾脏，并成功用于肝移植44例和肾移植92例。在受者中无一例发生细菌感染。

在供者PVB细菌培养为阳性的情况下，预防性使用抗生素能使肝脏和肾脏安全地移植至受者。全身感染的供者或许不是器官移植的禁忌证。

To summarize the preliminary experience of solid organ donation from donors complicated with systemic infection after citizens' death.

Clinical data of 47 donors after cardiac death admitted to Wengyuan County People's Hospital from January 2015 to May 2019 were retrospectively analyzed. The informed consents of all donors and recipients and/or family members were obtained and the local ethical committee approval was received. Among them, 38 patients were male and 9 female, aged (29±14) years on average. The results of bacterial culture from the donor peripheral venous blood (PVB), blood from central venous catheter (BCVC), tip of central venous catheter (TCVC), bronchial lavage fluid and urine were analyzed.

The length of ICU stay for 47 donors was 1-35 d with a median of 10 d. The positive rates of bacterial culture from PVB, BCVC, TCVC, bronchial aspirate and urine of donors were 6%(3/47), 4%(2/47), 6%(3/47), 17%(8/47) and 4%(2/47), respectively. For donors with positive PVB, gram-positive bacterial infection was observed in 1 case and gram-negative in 2 cases and Candida was isolated from 1 case. Candida was isolated from 3 donors and Escherichia coli was isolated from 2 donors through the urine samples. Recipients undergoing liver transplantation received antibiotic treatments according to drug sensitivity test of bacteria in PVB, whereas kidney transplantation recipients received antibiotic treatments according to drug sensitivity test of bacteria in PVB and urine samples. Other negative recipients were treated with empirical medication. A total of 47 livers and 94 kidneys were obtained and successfully applied in 44 cases of liver transplantation and 92 cases of kidney transplantation. No bacterial infection occurred in the recipients.

For donors with positive results of bacterial culture test, prophylactic use of antibiotics can contribute to the success of liver and kidney transplantation. Donors with systemic infection is probably not a contraindication for organ transplantation.