A simplified technique for the en bloc procurement of abdominal organs that is suitable for pancreas and small-bowel transplantation

被引:33
作者
Boggi, U
Vistoli, F
Del Chiaro, M
Signori, S
Pietrabissa, A
Costa, A
Bartolo, TV
Catalano, G
Marchetti, P
Del Prato, S
Rizzo, G
Jovine, E
Pinna, AD
Filipponi, F
Mosca, F
机构
[1] Univ Pisa, Dipartimento Oncol Trapianti & Nuove Tecnol Med, Div Chirurgia Gen & Trapianti, I-56124 Pisa, Italy
[2] Univ Pisa, Dipartimento Endocrinol & Metab, Sez Metab, I-56124 Pisa, Italy
[3] Azienda Osped Pisana, UO Nefrol & Trapianti, Pisa, Italy
[4] Univ Modena, Ctr Trapianti Fegato & Multiviscerale, I-41100 Modena, Italy
关键词
D O I
10.1016/j.surg.2003.10.011
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. Graft shortage makes multiorgan procurement mandatory. We describe the results Of a simplified method for the en bloc procurement of multiple organs, which permits isolated transplantation of all abdominal grafts, including the pancreas and the small bowel, to different recipients. Methods. Three hundred forty-three multiorgan procurements were done with a simplified en bloc technique. Results. None of the 1374 grafts that were procured sustained injuries that potentially precluded transplantation. Seventy-two grafts that were Procured from 18 donors (5 %) who were diagnosed with a neoplasm were discarded. Overall, 339 grafts that were procured from 325 donors were discarded because of specific contraindications, and 963 grafts (74 %) were transplanted. Ninety-seven pancreata were transplanted. In 3 instances the pancreas and the small bowel were procured simultaneously and transplanted to different recipients. A total of 287 liver grafts were also transplanted at 13 different institutions. In 42 instances, the liver was not allocated to our center. Forty liver teams (95 %) from I I different institutions agreed to procure their grafts according to the simplified en bloc technique. Our team performed 18 procurements, and a surgeon from the liver transplantation team, who was assisted by one of the members of our team, performed 22 procurements. In all, 576 kidneys were transplanted, either alone or simultaneously, with other abdominal grafts at 15 different institutions. Conclusions. This procurement method has high yields, allows pancreas and small-bowel procurement, and can be learned readily.
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页码:629 / 641
页数:13
相关论文
共 40 条
[1]
Logistics and technique for procurement of intestinal, pancreatic, and hepatic grafts from the same donor [J].
Abu-Elmagd, K ;
Fung, J ;
Bueno, J ;
Martin, D ;
Madariaga, JR ;
Mazariegos, G ;
Bond, G ;
Molmenti, E ;
Corry, RJ ;
Starzl, TE ;
Reyes, J .
ANNALS OF SURGERY, 2000, 232 (05) :680-687
[2]
Ackermann J R, 1968, Br J Urol, V40, P515, DOI 10.1111/j.1464-410X.1968.tb11842.x
[3]
BANDLIEN KO, 1988, AM SURGEON, V54, P578
[4]
Simultaneous pancreas-kidney transplantation reduces excess mortality in type 1 diabetic patients with end-stage renal disease [J].
Becker, BN ;
Brazy, PC ;
Becker, YT ;
Odorico, JS ;
Pintar, TJ ;
Collins, BH ;
Pirsch, JD ;
Leverson, GE ;
Heisey, DM ;
Sollinger, HW .
KIDNEY INTERNATIONAL, 2000, 57 (05) :2129-2135
[5]
TECHNIQUE FOR RAPID HARVESTING OF CADAVERIC RENAL AND PANCREATIC GRAFTS AFTER CIRCULATORY ARREST [J].
BJORKEN, C ;
LUNDGREN, G ;
RINGDEN, O ;
GROTH, CG .
BRITISH JOURNAL OF SURGERY, 1976, 63 (07) :517-519
[6]
BOILLOT O, 1993, TRANSPLANT P, V25, P2626
[7]
A COMPARISON OF STANDARD AND RAPID INFUSION METHODS OF LIVER PRESERVATION DURING MULTIORGAN PROCUREMENT [J].
CHRISTOPHI, C ;
MORGAN, B ;
MCINNES, I .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 1991, 61 (09) :692-694
[8]
DALESSANDRO AM, 1989, SURG GYNECOL OBSTET, V169, P324
[9]
STANDARDIZED QUICK EN-BLOC TECHNIQUE FOR PROCUREMENT OF CADAVERIC - LIVER GRAFTS FOR PEDIATRIC LIVER-TRANSPLANTATION [J].
DEGOYET, JD ;
REDING, R ;
HAUSLEITHNER, V ;
LERUT, J ;
OTTE, JB .
TRANSPLANT INTERNATIONAL, 1995, 8 (04) :280-285
[10]
MULTIVARIATE-ANALYSIS OF DONOR RISK-FACTORS FOR PANCREAS ALLOGRAFT FAILURE AFTER SIMULTANEOUS PANCREAS-KIDNEY TRANSPLANTATION [J].
DOUZDJIAN, V ;
GUGLIUZZA, KG ;
FISH, JC .
SURGERY, 1995, 118 (01) :73-81