Research progress of extracorporeal membrane oxygenation in liver transplantation using donation after cardiac death
MIAO Mengqiu1 MA Xueping1 MAO Fei1 ZUO Xiangrong2
1.Fouth School of Clinical Medicine, Nanjing Medical University, Jiangsu Province, Nanjing 210029, China;
2.Department of Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province, Nanjing 210029, China
Abstract：There is an ongoing shortfall of liver organ donor in the development of liver transplantation in the worldwide. Donation after cardiac death (DCD) is an important way to increase the number of liver donors at the present stage. The use of DCD livers was associated with a significantly higher risk of primary nonfunction and ischemic biliary complications because of prolonged warm ischemia time (WIT). It is a paramount research dilemma to devise how to avert or lessen the warm ischemia injury of DCD livers. Extracorporeal membrane oxygenation (ECMO) can minimize the WIT and injuries induced by warm ischemia through providing respiratory and circulatory support and increasing the perfusion of the organ. Moreover, ECMO facilitates safe transfer of potential DCD donors between hospitals and assessment of the potential DCD graft function, thus enhance the potential DCD donation success ratio and success rate of transplantation. Although, there are some ongoing controversies such as the ethical and technical issues about the use of ECMO in liver transplantation using DCD. It is believed that the application of ECMO will be an important measure to promote the development of liver transplantation using DCD with the continuous development of society and technology.
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2018, Vol. 15 
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