Wiener klinische Wochenschrift

, Volume 122, Issue 13–14, pp 441–451 | Cite as

Der potentielle Organspender – Evaluierung unter besonderer Berücksichtigung der Herzentnahme

  • Daniel Höfer
  • Arezu Aliabadi
  • Christian Ebner
  • Christoph Hörmann
  • Stephane Mahr
  • Regina Mascherbauer
  • Gerhard Pölzl
  • Albert Reiter
  • Andrä Wasler
  • Thomas Weber
  • Michael Zink
  • Andreas Zuckermann
  • Herwig Antretter
Konsensusbericht

Zusammenfassung

Angesichts der auch in Österreich vorherrschenden Knappheit an verfügbaren Organspendern für Herztransplantationen erscheint es dringlich notwendig, eine Optimierung von Spenderevaluierung und Management zu diskutieren. In der vorliegenden Arbeit werden allgemeine Spenderkriterien und herzspezifische Parameter detailliert diskutiert und im Zusammenhang mit der internationalen Literatur dargestellt. Es wird der "marginale" und im Gegensatz dazu der "optimale" Organspender definiert. Das Spendermanagement wird besprochen, wobei neben der hämodynamischen Optimierung auch auf zusätzliche intensivmedizinische Aspekte eingegangen wird. Erst die exakte Evaluierung erlaubt die individuelle Zuteilung des Organs zum passenden Empfänger und stellt somit insbesondere bei marginalen Spendern die Grundlage eines Therapieerfolgs dar.

Schlüsselwörter

Organspender Spender-Evaluierung Spender-Management Marginaler Spender 

Abbreviations:

HTX

Herztransplantation

MAP

mittlerer arterieller Blutdruck

ZVD

zentral venöser Druck

ZVO2

zentral venöse Sauerstoffsättigung

SVO2

gemischt venöse Sauerstoffsättigung

PAWP

pulmonal kapillärer Verschlussdruck

CI

cardiac index

paO2

arterieller Sauerstoffpartialdruck

paCO2

arterieller Kohlendioxydpartialdruck

PEEP

positiver endexpiratorischer Druck

AMV

Atemminutenvolumen

Hb

Hämoglobin

Na+

Serumnatrium

Hk

Hämatokrit

CRP

C-reaktives Protein

KHK

koronare Herzerkrankung

ADH

antidiuretisches Hormon

ECMO

extrakorporale Membranoxygenierung

VAD

ventricular assist device

EKG

Elektrokardiogramm

LV

linker Ventrikel

RV

rechter Ventrikel

LVEDD

linksventrikulärer enddiastolischer Durchmesser

RVEDD

rechtsventrikulärer enddiastolischer Durchmesser

LVEF

linksventrikuläre Auswurffraktion

TAPSE

tricuspid annular plain systolic excursion

ARDS

adult respiratory distress syndrome

CAG

Coronarangiographie

CT

Computertomographie

Evaluation of the potential organ donor with special regards to heart donation

Summary

Regarding limited availability of organ donors for heart transplantation, it is necessary to discuss optimal donor evaluation and donor management. In this manuscript general donor-related parameters as well as heart-specific parameters are discussed regarding international literature. In addition, "marginal" donors and in contrast "optimal" donors are defined. Donor management including optimal hemodynamic management and additional specific intensive care aspects are presented. Exact donor evaluation allows for matching the organ to the most suitable recipient and is therefore especially in the context of marginal donors a crucial step within transplantation process.

Keywords

Organ donor Donor evaluation Donor management Marginal donor 

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Daniel Höfer
    • 1
  • Arezu Aliabadi
    • 2
  • Christian Ebner
    • 3
  • Christoph Hörmann
    • 4
  • Stephane Mahr
    • 2
  • Regina Mascherbauer
    • 3
  • Gerhard Pölzl
    • 5
  • Albert Reiter
    • 6
  • Andrä Wasler
    • 7
  • Thomas Weber
    • 8
  • Michael Zink
    • 9
  • Andreas Zuckermann
    • 2
  • Herwig Antretter
    • 1
  1. 1.Universitätsklinik für HerzchirurgieMedizinische Universität InnsbruckInnsbruckAustria
  2. 2.Klinische Abteilung für Herz-Thoraxchirurgie der Universitätsklinik für ChirurgieMedizinische Universität WienWienAustria
  3. 3.Abteilung für KardiologieKrankenhaus der Elisabethinen LinzLinzAustria
  4. 4.Abteilung für Anästhesiologie und IntensivmedizinLandesklinikum St. PöltenSt. PöltenAustria
  5. 5.Universitätsklinik für KardiologieMedizinische Universität InnsbruckInnsbruckAustria
  6. 6.Abteilung für Anästhesiologie und IntensivmedizinLandesklinikum AmstettenAmstettenAustria
  7. 7.Klinische Abteilung für Transplantationschirurgie der Universitätsklinik für ChirurgieMedizinische Universität GrazGrazAustria
  8. 8.Abteilung für Innere Medizin II, Kardiologie, IntensivmedizinKlinikum Wels-GrieskirchenWels-GrieskirchenAustria
  9. 9.Anästhesiologie und IntensivmedizinKH der Barmherzigen Brüder St. Veit/GlanSt. VeitAustria

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