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KMID : 0361120140280040250
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Korean Journal of Transplantation
2014 Volume.28 No. 4 p.250 ~ p.253
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Improvement of Hypoxemia by Inhaled Nitric Oxide Gas Therapy in Potential Deceased Do
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Park Min-Ji
Yun Hyo-Jin
Lee Kyung-Ho
Cho A-Reum
Choi In-Seok
Moon Joo-Ik
Yoon Se-Hee
Hwang Won-Min
Yun Sung-Ro
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Abstract
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Potential diseased donors manifest altered physiological changes associated with pulmonary edema, profound hemodynamic and metabolic abnormalities. These derangements may be more significant after apnea tests which result in severe hypoxemia and cardiovascular complications. Nitric oxide (NO) inhalation therapy can be applied following apnea tests in the brain-dead donor whose ventilator support has been maintained with high positive end-expiratory pressure. Inhalation of NO gas causes selective dilation of blood vessels in only those lung segments that are actively participating in gas exchange (oxygen and carbon dioxide) at the alveolar capillary level. In other words, this increases the blood flow to areas of the lung where oxygen is being provided and thus improves oxygen levels in the body. We report on the case of a 14-year-old organ donor with inhaled NO therapy after apnea testing. The duration of NO inhalation therapy was 14 hours. This deceased donor, who suffered with severe hypoxemia and hemodynamic instability after apnea tests, improved after NO gas therapy and adequate vasoactive drugs. NO gas therapy will be helpful for improving oxygen delivery to pulmonary vessels. Two kidneys and one liver were successfully retrieved from donors. These recipients had well preserved function of allografts. Therefore, NO inhalation can be help￢ful in improvement of hypoxemia and increasing organ availability in deceased organ donors.
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KEYWORD
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Nitric oxide, Brain death, Anoxia, Organ transplantation
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