ORGAN PRESERVATION AND PROCUREMENT

A.V. Kolsanov¹, A.A. Mironov², N.E. Neljubina³, B.I. Yaremin^1
1Organ Transplantation Unit, Samara Center For Organ And Tissue Transplantation, Samara State Medical University, Samara/RUSSIAN FEDERATION, ²Organ Donation Unit, Samara Center For Organ And Tissue Transplantation, Samara State Medical University, Samara/RUSSIAN FEDERATION, ³Neurology Department, Samara State Medical University, Samara/RUSSIAN FEDERATION

Body: Introduction. Apnea Oxygenation Test is the key point of brain death statement. After the moment when ventilation discontinued and oxygen intratracheal flow started it is necessary to keep blood saturation high. In Russian low it is necessary to get oxygen partial pressure up to 200 mm Hg to test may be started. This contribution can be hardly achieved in all cases especially in patients with anemia, pneumonia, lung edema, long history of previous ventilation etc. It makes apnea test potentially dangerous and difficult. It is necessary to solve the following tasks: find the drugs that prevent ischemic damage, study their impact on the levels of arterial blood gas, assess their impact on the time spent on conducting the test. Methods. We use legally registered in Russia "Perftoran" solution (perfluordecaline and perfluormethylcyclohexylpiperidine 2:1 in emulsion). Perftoran is usually using as oxygen transport agent, "artificial blood". We use Perftoran solution IV in a dose of 200 ml prior the test. The main group was 16 patients from intensive care units with the clinic of the deep atonic coma (Glasgow scale 0-1). This patients were under observation of Independent Neurophysiological Unit of Samara State Medical University. There was 15 same patients in a group of comparison. Both groups are comparable. Results. Introduction of Perftoran 200 ml significantly increases the initial level of partial oxygen pressure in arterial blood. Thus, the introduction of this medication, the average value of this index amounted to 436,4±4,6 mm Hg, when the control group it was at 228,2±5,6 mm. High values of oxygen pressure persist throughout the test, until we reach the target level of pCO₂. The level of oxygenation after Perftoran use was 284,2±6,7 mmHg, vs. 114,0±7,1 mm in its absence. There is no significant distinctions between pCO₂ level in both groups.
Conclusion.
As Perftorsn use does not affect CO₂ level, the run trigger for respiratory center, the high specificity of the test remains. Thus, the use the perftoran during the apnea oxygenation test can significantly protect the patient, increasing the partial pressure of oxygen and, thus, carrying out as anti-defense agents. It reduces the time of the statement, making it more accessible. Use of Perftoran with a finding of brain death anywhere in the literature previously been described, but the resulting experience allows us to recommend its widespread use.

Disclosure: All authors have declared no conflicts of interest.