Applications of extracorporeal membrane oxygenation and continuous renal replacement therapy for maintaining organs of potential organ donors with cardiopulmonary failure after brain death

Objective To explore the functions of extracorporeal membrane oxygenation (ECMO) with continuous renal replacement therapy (CRRT) for potential organ donors with cardiopulmonary failure after brain death and boost the coefficient of utilization of livers. Methods Analysis was conducted for clinical data of 5 donors with cardiopulmonary failure after brain death and their corresponding recipients from July 2015 to May 2017. Five donors received the treatments of ECMO and CRRT. The relevant data included changes of blood pressure, dosage of vasoactive agents, liver function, renal function and urine volume of those treated donors. Also liver functions of liver recipients were observed. Then the clinical data of 18 normal DBD and their liver recipients were compared. Results After ECMO/CRRT, donor blood pressures rose and the doses of vasoactive agents decreased. Meanwhile urine volume also increased. Finally 4/5 livers could be transplanted. And 10 kidneys were transplanted successfully. There was no significant inter-group difference of liver function. Conclusions The applications of ECMO and CRRT improve liver function of donors with cardiopulmonary failure after brain death and boost the rates of organ donation and utilization. Key words: Extracorporeal membrane oxygenation; Continuous renal replacement therapy; Donation after brain death; Liver transplantation