CN117898283B - Device to keep organs alive from non-heart-beating donors - Google Patents
Device to keep organs alive from non-heart-beating donors Download PDFInfo
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- CN117898283B CN117898283B CN202311841873.0A CN202311841873A CN117898283B CN 117898283 B CN117898283 B CN 117898283B CN 202311841873 A CN202311841873 A CN 202311841873A CN 117898283 B CN117898283 B CN 117898283B
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Classifications
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- A—HUMAN NECESSITIES
- A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
- A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
- A01N1/00—Preservation of bodies of humans or animals, or parts thereof
- A01N1/10—Preservation of living parts
- A01N1/14—Mechanical aspects of preservation; Apparatus or containers therefor
- A01N1/142—Apparatus
- A01N1/143—Apparatus for organ perfusion
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- General Health & Medical Sciences (AREA)
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Abstract
本发明涉及器官移植设备技术领域，特别涉及一种保持无心跳供体脏器活性的装置。该装置包括第一循环管路、输入管和输出管，第一循环管路包括第一连接端部和第二连接端部，第一连接端部和第二连接端部之间设置有储血器、血液泵和氧合器，输入管的一端连接于第一连接端部，输入管背离第一连接端部的一端连接于供体，输出管的一端连接于第二连接端部，输出管背离第二连接端部的一端连接于供体，其中，第一循环管路、输入管、供体和输出管形成一闭合的血液循环回路。该装置用于在心脏停跳且供体生理死亡后，向供体内灌注血液，以保持供体内脏器的活性，从而降低器官在供体心脏停跳到摘取的这段时间内的热缺血打击。
The present invention relates to the technical field of organ transplantation equipment, and in particular to a device for maintaining the activity of a heart-free donor organ. The device comprises a first circulation pipeline, an input tube and an output tube, wherein the first circulation pipeline comprises a first connection end and a second connection end, a blood reservoir, a blood pump and an oxygenator are arranged between the first connection end and the second connection end, one end of the input tube is connected to the first connection end, the end of the input tube away from the first connection end is connected to the donor, one end of the output tube is connected to the second connection end, and the end of the output tube away from the second connection end is connected to the donor, wherein the first circulation pipeline, the input tube, the donor and the output tube form a closed blood circulation loop. The device is used to perfuse blood into the donor after the heart stops beating and the donor dies physiologically, so as to maintain the activity of the donor's internal organs, thereby reducing the warm ischemic shock of the organ during the period from the donor's heart stopping to the removal.
Description
Technical Field
The invention relates to the technical field of organ transplantation equipment, in particular to a device for keeping the organ activity of a heart-beat-free donor.
Background
Organ transplantation is a gold standard for treating end-stage organ disease and in the current commonly used organ transplantation protocol, the organ is required to undergo a long time of ischemic injury attack from its acquisition to its transplantation to the patient. Ischemic injury of organs is the most important factor affecting the prognosis of transplantation, and can lead to various complications, reducing patient survival rate.
The ischemic injury of the organ comprises thermal ischemic injury of the organ and cold ischemic injury of the organ, wherein the thermal ischemic injury of the organ refers to injury caused by ischemia or blood flow interruption of the organ when the organ is not cooled, and the damage to the organ is most serious in the stage, because the blood flow is interrupted during the thermal ischemia, but organ tissues continue to metabolize, at the moment, the metabolic level of the organ is still high due to lack of oxygen and various metabolic substrate supplies, so that the thermal ischemic injury of the organ occurs faster and to a heavier degree, and can still perform anaerobic metabolism after the oxygen is consumed, but metabolic products cannot be removed, acidosis can be caused, and nutrient and enzyme systems necessary for metabolism are also consumed. The cold ischemia injury of the organ refers to the injury caused by ischemia of the organ at low temperature (0-4 ℃), and the damage to the organ at the stage is usually minimum because the metabolism of the organ at the low temperature is obviously reduced, the oxygen consumption is reduced and the tolerance of the organ to ischemia can be increased, and the process of preserving the organ is basically the cold ischemia process.
At present, in the conventional organ transplantation, the organ is very poor in tolerance to the hot ischemic attack, and the organ is easy to lose the transplantation condition, so that the hot ischemic attack during the period of time when the organ is extracted from the donor after the physiological death of the donor is not well improved and solved, and the cooling is required to be quickly cleaned after the organ is extracted to reduce the hot ischemic time.
Disclosure of Invention
The invention mainly aims to provide a device for keeping the organ activity of a heart-free donor, and aims to solve the technical problem that after the physiological death of the donor, the organ is removed from the donor and is damaged due to the hot ischemia striking.
To achieve the above object, the present invention provides a device for maintaining the activity of an organ of a non-heart-beating donor, for perfusing blood into the donor after physiological death of the donor to maintain the activity of the organ in the donor, the device for maintaining the activity of the non-heart-beating donor organ comprising:
The first circulating pipeline comprises a first connecting end part and a second connecting end part, a blood storage device, a blood pump and an oxygenator are arranged between the first connecting end part and the second connecting end part, the blood storage device is used for storing blood, the blood pump is used for providing power for the flow of the blood, and the oxygenator is used for realizing the air-blood exchange of the blood;
An input tube, one end of which is connected to the first connection end, and one end of which is away from the first connection end is connected to the donor;
One end of the output pipe is connected to the second connecting end part, and one end of the output pipe, which deviates from the second connecting end part, is connected to the donor;
Wherein the first circulation line, the inlet line, the donor and the outlet line form a closed blood circulation circuit.
In some embodiments, the first circulation line further comprises:
the first pinch-off valve is arranged at one end, close to the first connecting end part, of the first circulating pipeline;
the second pinch-off valve is arranged at one end, close to the second connecting end part, of the first circulating pipeline;
The second circulation pipeline is arranged between the first pinch-off valve and the second pinch-off valve, comprises the blood reservoir, the blood pump and the oxygenator, and is provided with a third pinch-off valve;
The first pinch-off valve and the second pinch-off valve are in an open state, and when the third pinch-off valve is in a closed state, blood circulation is achieved through the first circulation pipeline, blood flows through the blood storage device, the blood pump, the oxygenator and the donor, the first pinch-off valve and the second pinch-off valve are in a closed state, and when the third pinch-off valve is in an open state, blood circulation is achieved through the second circulation pipeline, and blood flows through the blood storage device, the blood pump and the oxygenator.
In some embodiments, the second circulation pipeline is further provided with a heat exchanger, the heat exchanger is connected with a hot water tank, the hot water tank comprises a liquid inlet and a liquid outlet, the liquid inlet and the liquid outlet are communicated with the heat exchanger through pipelines, so that solution in the hot water tank flows into the heat exchanger through the pipelines from the liquid outlet, and flows back to the hot water tank from the heat exchanger through the pipelines from the liquid inlet, and heat exchange of blood in the first circulation pipeline or the second circulation pipeline is achieved.
In some embodiments, the conduit is provided with a water pump for increasing the flow rate of the solution within the hot water tank.
In some embodiments, the hot water tank is provided with a first level sensor for monitoring the level of the solution in the hot water tank and a first temperature sensor for monitoring the temperature of the solution in the hot water tank.
In some embodiments, the second circulation line is further provided with a flow meter for monitoring the flow of blood in the first circulation line or the second circulation line and an oxygen blood monitor for monitoring the oxygen content of blood in the first circulation line and the second circulation line.
In some embodiments, the second circulation line is further provided with a bubble removal device for removing bubbles in the blood circulation in the first circulation line or the second circulation line and a thrombus filtering device for filtering out thrombus in the blood circulation in the first circulation line or the second circulation line.
In some embodiments, the reservoir is provided with a second level sensor for monitoring the level of blood in the reservoir and a second temperature sensor for monitoring the temperature of blood in the reservoir.
In some embodiments, the reservoir is provided with a filling port for replenishing the reservoir with blood.
In some embodiments, a pressure sensor is provided at an end of the first circulation line proximate to the first connection end for monitoring blood pressure of blood flowing from the first circulation line into the donor.
Compared with the prior art, the invention has the beneficial effects that:
In accordance with the present invention, there is provided a device for maintaining the activity of an organ of a non-beating donor for perfusing blood into the donor after cardiac arrest and physiological death of the donor to maintain the activity of the organ in the donor, thereby reducing the thermal ischemic stroke of the organ during the period from cardiac arrest to harvest of the donor. The device comprises a first circulation pipeline, an input pipe and an output pipe, wherein the first circulation pipeline comprises a first connecting end part and a second connecting end part, and a blood storage device, a blood pump and an oxygenator are arranged between the first connecting end part and the second connecting end part of the first circulation pipeline. One end of the input tube is connected to the first connection end and the other end of the input tube is connected to the donor, for example, the input tube may be inserted over the femoral artery of the donor. One end of the efferent vessel is connected to the second connection end and the other end of the efferent vessel is connected to the donor, for example, the efferent vessel may be inserted into the femoral vein of the donor. The first circulation line, the inlet line, the donor and the outlet line form a closed blood circulation circuit. Specifically, the blood in the blood storage device flows along the first circulation pipeline under the drive of the blood pump, after the blood flows through the oxygenator to realize the air-blood exchange of the blood, the blood enters the donor from the input pipe, so that nutrients such as oxygen and the like are provided for organs in the donor, normal metabolic activities of the organs are kept, the blood can also take away metabolic wastes generated by the organs, and after the blood circulates in the donor, the blood flows out of the donor from the output pipe and circulates along the first circulation pipeline.
The device for keeping the activity of the heart-free donor organ is equivalent to establishing an artificial heart and an artificial lung outside a donor, when the heart of the donor stops and determines physiological death, the device can be used for continuously ensuring the blood circulation of the internal organ of the donor (mainly relying on a blood pump in the device to drive the blood to flow so as to realize the blood circulation) and the oxygen transmission (mainly relying on an oxygenator in the device to realize the oxygen transmission in blood), and transporting carbon dioxide generated by the metabolism of the internal organ of the donor to the outside of the donor, and realizing the exchange of oxygen and carbon dioxide in the blood outside the donor, thereby realizing the normal physiological activity of the internal organ of the donor still after the heart of the donor stops, continuously ensuring the physiological activity of the internal organ of the donor, effectively avoiding the thermal ischemia attack of the internal organ of the donor in the period of time from the heart of the donor stops to be picked, thereby avoiding the thermal ischemia damage of the internal organ of the donor, and creating a good transplanting condition for the subsequent organ transplantation.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are required in the embodiments or the description of the prior art will be briefly described, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and other drawings may be obtained according to the structures shown in these drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic view showing the overall connection of a device for maintaining the organ activity of a heart-free donor according to an embodiment of the present invention;
FIG. 2 is a schematic diagram of a monitoring system of a device for maintaining organ activity of a non-heart-beating donor according to an embodiment of the present invention;
fig. 3 is a flowchart illustrating a method for using a device for maintaining organ activity of a heart-free donor according to another embodiment of the present invention.
Reference numerals illustrate:
100-a first circulation line;
110-first connection end, 120-second connection end, 130-first pinch-off valve, 140-second pinch-off valve, 150-pressure sensor;
200-a second circulation line;
210-third pinch-off valve, 220-blood reservoir, 230-blood pump, 240-oxygenator, 250-heat exchanger, 260-hot water tank, 270-flowmeter, 280-blood oxygen monitor, 290-bubble removal device, 291-thrombus filtering device;
221-a second liquid level sensor, 222-a second temperature sensor, 261-a water pump, 262-a first liquid level sensor, 263-a first temperature sensor;
300-input tube;
400-output tube;
500-donor;
600-a control circuit board;
700-touch display screen;
800-alarm.
The achievement of the objects, functional features and advantages of the present invention will be further described with reference to the accompanying drawings, in conjunction with the embodiments.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and fully with reference to the accompanying drawings, in which it is evident that the embodiments described are only some, but not all embodiments of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It should be noted that, if the directional indication (such as up, down, left, right, front, and rear) is included in the embodiments of the present invention, the directional indication is only used to explain the relative positional relationship, movement, etc. between the components at a particular pose and if the particular pose changes, the directional indication changes accordingly.
In addition, if there is a description of "first", "second", etc. in the embodiments of the present invention, the description of "first", "second", etc. is for descriptive purposes only and is not to be construed as indicating or implying a relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include at least one such feature. In addition, if "and/or", "and/or" and/or "are used throughout, the meaning includes three parallel schemes, for example," a and/or B ", including a scheme, or B scheme, or a scheme where a and B meet simultaneously. In addition, the technical solutions of the embodiments may be combined with each other, but it is necessary to base that the technical solutions can be realized by those skilled in the art, and when the technical solutions are contradictory or cannot be realized, the combination of the technical solutions should be considered to be absent and not within the scope of protection claimed in the present invention.
Organ transplantation is a gold standard for treating end-stage organ disease and in the current commonly used organ transplantation protocol, the organ is required to undergo a long time of ischemic injury attack from its acquisition to its transplantation to the patient. Ischemic injury of organs is the most important factor affecting the prognosis of transplantation, and can lead to various complications, reducing patient survival rate.
The ischemic injury of the organ comprises thermal ischemic injury of the organ and cold ischemic injury of the organ, wherein the thermal ischemic injury of the organ refers to injury caused by ischemia or blood flow interruption of the organ when the organ is not cooled, and the damage to the organ is most serious in the stage, because the blood flow is interrupted during the thermal ischemia, but organ tissues continue to metabolize, at the moment, the metabolic level of the organ is still high due to lack of oxygen and various metabolic substrate supplies, so that the thermal ischemic injury of the organ occurs faster and to a heavier degree, and can still perform anaerobic metabolism after the oxygen is consumed, but metabolic products cannot be removed, acidosis can be caused, and nutrient and enzyme systems necessary for metabolism are also consumed. The cold ischemia injury of the organ refers to the injury caused by ischemia of the organ at low temperature (0-4 ℃), and the damage to the organ at the stage is usually minimum because the metabolism of the organ at the low temperature is obviously reduced, the oxygen consumption is reduced and the tolerance of the organ to ischemia can be increased, and the process of preserving the organ is basically the cold ischemia process.
At present, in the conventional organ transplantation, the organ is very poor in tolerance to the hot ischemic attack, and the organ is easy to lose the transplantation condition, so that the hot ischemic attack during the period of time when the organ is extracted from the donor after the physiological death of the donor is not well improved and solved, and the cooling is required to be quickly cleaned after the organ is extracted to reduce the hot ischemic time.
In order to solve the technical problem that the organ is damaged due to the thermal ischemia beating during the period of time when the organ is removed from the donor 500 after the physiological death of the donor 500, referring to fig. 1 to 2, an embodiment of the present invention provides a device for maintaining the activity of the organ of the non-heart-beating donor 500, which is used for filling blood into the donor 500 to maintain the activity of the organ in the donor 500 after the physiological death of the donor 500, the device for maintaining the activity of the organ of the non-heart-beating donor 500 provided by the embodiment comprises a first circulation pipeline 100, an input pipe 300 and an output pipe 400, wherein the first circulation pipeline 100 comprises a first connection end 110 and a second connection end 120, a blood reservoir 220, a blood pump 230 and an oxygenator 240 are arranged between the first connection end 110 and the second connection end 120, the blood reservoir 220 is used for storing blood, the blood pump 230 is used for providing power for the flow of the blood, the oxygenator 240 is used for realizing the exchange of the air and the blood, one end of the input pipe 300 is connected to the first connection end 110, one end of the input pipe 300 is connected to the donor 500, one end of the output pipe 400 is connected to the first connection end of the output pipe 400, one end of the output pipe 300 is connected to the first connection end of the output pipe 400, the output pipe is connected to the second connection end is connected to the first connection end 400, the output pipe 400, and the other end is connected to the first connection end 400, and the output pipe is connected to the first connection 500, and the first circulation pipeline 500 and the other end is connected to the first connection 500, 500 and the second connection end 500 is connected.
Specifically, in the technical solution of the present embodiment, a device for maintaining the activity of the organ of the non-heart-beating donor 500 is provided, which is used for perfusing blood into the donor 500 after the heart is stopped and the donor 500 is physiologically dead, so as to maintain the activity of the organ in the donor 500, thereby reducing the thermal ischemia striking of the organ during the period from the heart stop to the harvest of the donor 500. The device comprises a first circulation line 100, an inlet line 300 and an outlet line 400, wherein the first circulation line 100 comprises a first connection end 110 and a second connection end 120, and a blood reservoir 220, a blood pump 230 and an oxygenator 240 are arranged between the first connection end 110 and the second connection end 120 of the first circulation line 100. One end of the input tube 300 is connected to the first connection end 110, and the other end of the input tube 300 is connected to the donor 500. One end of the output tube 400 is connected to the second connection end 120, and the other end of the output tube 400 is connected to the donor 500. The first circulation line 100, the input line 300, the donor 500 and the output line 400 form a closed blood circulation circuit. Specifically, the blood in the blood reservoir 220 flows along the first circulation line 100 under the driving of the blood pump 230, and flows through the oxygenator 240 to exchange the blood with the oxygen, and then enters the donor 500 from the input tube 300, so as to provide nutrients such as oxygen for the viscera in the donor 500, so as to maintain the normal metabolic activity of the viscera, and the blood can also take away the metabolic waste generated by the viscera, and after the blood circulates in the donor 500, the blood flows out of the donor 500 from the output tube 400 and circulates along the first circulation line 100.
In some embodiments, the device for maintaining the organ activity of the non-heart-beating donor 500 provided in this embodiment may be used to maintain the normal physiological activity of the intra-abdominal organ of the donor 500, and in order to ensure that the intra-thoracic organ is not affected (in the actual operation process, the priority of intra-thoracic organ extraction is greater than that of intra-abdominal organ extraction, so that the device provided in this embodiment needs to be used to maintain the physiological activity of the intra-abdominal organ, and avoid the intra-abdominal organ damage caused by the hot ischemia attack of the intra-abdominal organ), the blocking balloon may be placed in the descending aorta of the donor 500 before the input tube 300 is inserted into the donor 500, and the blood circulation between the thoracic cavity and the abdominal cavity is completely isolated by using the blocking balloon, so that the intra-thoracic organ is not perfused, thereby ensuring the normal operation treatment of the intra-thoracic organ. In the process of formally inserting the input tube 300 and the output tube 400 into the donor 500, the input tube 300 may be inserted into the femoral artery of the donor 500, and the output tube 400 may be inserted into the femoral vein of the donor 500, so that it is possible to ensure that the blood flow rate flowing into the donor 500 from the first circulation line 100 is sufficiently large, thereby timely transporting nutrients such as oxygen to the intra-abdominal organs through the blood, and timely taking metabolic wastes of the intra-abdominal organs out of the donor 500, and in addition, since the donor 500 is only brain dead but not heart dead when the input tube 300 and the output tube 400 are inserted into the donor 500, the insertion of the output tube 400 from the femoral vein is easiest, and the influence on the donor 500 is minimized. Alternatively, the efferent vessel 400 may be inserted into the cervical vein, the shoulder vein, etc. of the donor 500, and the efferent vessel 400 may be inserted into the main chest and abdomen vein, since the vein of the donor 500 is not blocked in practice.
The apparatus for maintaining the organ activity of the non-heart-beating donor 500 according to the present embodiment corresponds to an artificial heart and an artificial lung established outside the donor 500, wherein the blood pump 230 corresponds to the artificial heart and the oxygenator 240 corresponds to the artificial lung. When the heart of the donor 500 stops and the physiological death is determined, the device can be used for continuously ensuring the blood circulation (mainly by virtue of the blood pump 230 in the device to drive the blood to flow so as to realize the blood circulation) and the oxygen transmission (mainly by virtue of the oxygenator 240 in the device to realize the oxygen transmission in the blood) of the internal organs of the donor 500, and transporting the carbon dioxide generated by the metabolism of the internal organs of the donor 500 to the outside of the donor 500, and realizing the exchange of the oxygen and the carbon dioxide in the blood outside the donor 500, so that the normal physiological activity of the internal organs of the donor 500 is still maintained after the heart of the donor 500 stops, the physiological activity of the internal organs of the donor 500 is continuously ensured, the hot ischemia striking of the internal organs of the donor 500 in the period of time when the heart of the donor 500 stops to be taken is effectively avoided, the hot ischemia damage of the internal organs of the donor 500 is avoided, and a good transplanting condition is created for the subsequent organ transplantation.
In some embodiments, the perfusate flowing from the first circulation line 100 into the donor 500 may be a mixed liquid of a blood expander and blood, or a perfusate of other components, so long as the physiological activity of the viscera in the heart-free donor 500 can be ensured.
It should be noted that, the blood reservoir 220, the blood pump 230, the oxygenator 240 and the blocking balloon in the present embodiment are common devices in the art, so the structures and the usage of the blood reservoir 220, the blood pump 230, the oxygenator 240 and the blocking balloon will not be described in detail.
In some embodiments, referring to fig. 1, the first circulation line 100 further includes a first pinch-off valve 130, a second pinch-off valve 140, and a second circulation line 200, the first pinch-off valve 130 is disposed at an end of the first circulation line 100 near the first connection end 110 for on-off of blood at the input tube 300, the second pinch-off valve 140 is disposed at an end of the first circulation line 100 near the second connection end 120 for on-off of blood at the output tube 400, the second circulation line 200 is disposed between the first pinch-off valve 130 and the second pinch-off valve 140, and the second circulation line 200 includes the blood reservoir 220, the blood pump 230, and the oxygenator 240, and the second circulation line 200 is provided with a third pinch-off valve 210 for on-off of blood at the second circulation line 200. When the first pinch-off valve 130 and the second pinch-off valve 140 are in an open state and the third pinch-off valve 210 is in a closed state, blood circulation is achieved in the first circulation line 100, and blood flows through the blood reservoir 220, the blood pump 230, the oxygenator 240 and the donor 500, and when the first pinch-off valve 130 and the second pinch-off valve 140 are in a closed state and the third pinch-off valve 210 is in an open state, blood circulation is achieved in the second circulation line 200, and blood flows through the blood reservoir 220, the blood pump 230 and the oxygenator 240.
Specifically, in order to ensure that various indexes of blood satisfy the state of normal vital activities of the human body when the blood is filled into the donor 500, such as blood pressure, temperature, oxygen content, flow rate, etc., the safety of the blood filling into the donor 500 is improved, so that the pre-filling is performed in the second circulation line 200 before the blood is formally filled into the donor 500 through the first circulation line 100. When the pre-filling is performed, the first pinch-off valve 130 and the second pinch-off valve 140 are closed, and the third pinch-off valve 210 is opened, so that blood only circulates in the second circulation line 200, and the blood flows through the blood reservoir 220 and the oxygenator 240 in the second circulation line 200 under the pumping action of the blood pump 230, and the bubbles in the second circulation line 200 are removed and fully infiltrate the second circulation line 200 while testing whether the blood reservoir 220, the blood pump 230 and the oxygenator 240 can normally operate, thereby minimizing the probability of thrombosis in the circulation line during the formal blood filling and minimizing the damage of the circulation line to blood cells and platelets. After the blood circulates through several rounds of the second circulation line 200 and the index of the blood (e.g., oxygen content) satisfies the blood condition in the human body having normal physiological activities, the first pinch-off valve 130 and the second pinch-off valve 140 are opened while the third pinch-off valve 210 is closed, so that the blood circulates only in the first circulation line 100, and the blood stored in the blood reservoir 220 flows from the input tube 300 into the donor 500 through the blood pump 230 while receiving the blood flowing from the output tube 400 in the donor 500. During this time, the oxygenator 240 continuously supplies oxygen into the blood and performs gas exchange in the blood to ensure that the oxygen content in the blood is at a level of a human body having normal physiological activities, and reduces the carbon dioxide content in the blood.
In some embodiments, a use case of the present device for maintaining organ activity in a heart-free donor 500 is provided, for example, after brain death of the donor 500 and consent from donation of an organ by family members, the device provided in this embodiment is used to cannulate the input tube 300 and output tube 400 to the donor 500, and a blocking balloon is placed into the descending aorta of the donor 500 via the input tube 300. After the pipeline is connected, the device is started, firstly, the device reaches a pre-perfusion state, then the donor 500 breathing machine is removed, after a doctor declares that the heart of a patient stops jumping, the first pinch-off valve 130 and the second pinch-off valve 140 are rapidly opened, the third pinch-off valve 210 is closed, and a preset blocking balloon is inflated or filled with liquid, so that the blocking balloon is inflated to block arterial connection between the thoracic cavity and the abdominal cavity, the device is switched to a formal perfusion state, and the heart-free donor 500 is perfused with blood, so that the activity of the viscera of the donor 500 is kept.
The device for keeping the activity of the organ of the heart-beat-free donor 500 provided by the embodiment adopts a pre-perfusion design, and can pre-heat the device in advance, so that the device reaches a stable working state in advance, and detects whether the device can work normally or not, thereby preventing medical loss caused by the condition that the organ of the donor 500 loses transplantation due to the fact that the device cannot work normally. In addition, through pre-perfusion, the blood can reach the normal material content requirement in advance, and after the physiological death of the donor 500, the blood meeting the requirement can be perfused into the donor 500 as soon as possible, so that the thermal ischemia time of the viscera in the donor 500 is shortened or even eliminated.
In some embodiments, referring to fig. 1, the second circulation line 200 is further provided with a heat exchanger 250, the heat exchanger 250 is connected with a hot water tank 260, the hot water tank 260 includes a liquid inlet and a liquid outlet, the liquid inlet and the liquid outlet are communicated with the heat exchanger 250 through a pipe, so that a solution in the hot water tank 260 flows into the heat exchanger 250 through the pipe from the liquid outlet, and flows back to the hot water tank 260 from the heat exchanger 250 through the pipe from the liquid inlet to realize heat exchange of blood in the first circulation line 100 or the second circulation line 200.
Specifically, in order to ensure that the organs in the non-heart-beating donor 500 have normal physiological activities, blood having a temperature close to the normal body temperature (typically about 37 ℃) needs to be infused into the donor 500, and in this embodiment, a heat exchanger 250 is disposed on the second circulation line 200, and the blood in the circulation line can exchange heat in the heat exchanger 250 to raise or lower the temperature of the blood to the normal body temperature (typically about 37 ℃) so as to maintain the infusion temperature of the organs in the donor 500 and maintain the normal physiological activities of the organs in the donor 500.
Since the second circulation line 200 is a part of the first circulation line 100, when the flow direction of the blood is switched from the second circulation line 200 to the first circulation line 100, the heat exchanger 250 is still capable of conducting heat and heat to the blood in the device, so that the temperature of the blood in the device is always maintained at a specified temperature (typically about 37 ℃ C., similar to the normal body temperature of a human body).
In some embodiments, an electric heating device and a cooling device are built in the hot water tank 260, the solution inside the hot water tank 260 can be heated by the electric heating device, and the solution inside the hot water tank 260 can be cooled by the cooling device, so as to realize temperature adjustment of the solution inside the hot water tank 260, and the solution inside the hot water tank 260 can be water, for example. The hot water tank 260 may further be provided with a water inlet, and when the solution is continuously consumed, the solution can be added into the hot water tank 260 through the water inlet, so as to ensure that sufficient solution in the hot water tank 260 conducts heat and heat to the blood in the heat exchanger 250, thereby maintaining the temperature of the blood in the device at a specified temperature (generally about 37 ℃ and similar to the normal body temperature of a human body).
In some embodiments, referring to fig. 1, the tubing is provided with a water pump 261 for increasing the flow rate of the solution within the hot water tank 260. Specifically, the solution in the hot water tank 260 can be quickly pumped to the heat exchanger 250 by the water pump 261, and the solution in the heat exchanger 250 is quickly pumped back to the hot water tank 260, so that the solution can be quickly circulated between the heat exchanger 250 and the hot water tank 260, the temperature of the heat exchanger 250 is maintained at a specified temperature (generally about 37 ℃ and similar to the normal body temperature of a human body), and the heat exchange efficiency of the blood in the device in the heat exchanger 250 is improved.
In some embodiments, referring to fig. 1, the hot water tank 260 is provided with a first level sensor 262 and a first temperature sensor 263, the first level sensor 262 being used to monitor the level of the solution in the hot water tank 260 and the first temperature sensor 263 being used to monitor the temperature of the solution in the hot water tank 260.
Specifically, since the survival condition of the organs in the heart-free donor 500 is very severe, a slight carelessness may cause damage to the organs and loss of the transplantation condition, resulting in serious medical errors, in order to more accurately monitor the content and temperature of the solution in the hot water tank 260, avoid accidents caused by carelessness of medical staff, ensure that the blood in the device can smoothly realize heat exchange, and the hot water tank 260 is provided with the first liquid level sensor 262 and the first temperature sensor 263. When the solution content in the hot water tank 260 is too low or too high, the first liquid level sensor 262 will trigger an alarm to remind medical staff to timely add water into the hot water tank 260 or drain water from the hot water tank 260, so that the problem that the effective heat transfer to the blood cannot be performed due to the too low solution content is prevented, or the problem that the solution overflows due to the too high solution content is prevented, so that the solution is sprinkled on the floor or the medical instrument, and accidents such as slipping of the medical staff or the connection of the medical instrument are caused. Similarly, when the temperature of the solution in the hot water tank 260 is too low or too high, the first temperature sensor 263 can trigger an alarm to remind the medical staff to heat or cool the solution in the hot water tank 260 in time, so as to prevent the blood from not reaching the designated temperature (generally about 37 ℃ and similar to the normal body temperature of the human body) due to the too low temperature of the solution, or prevent the active substances in the blood from being deactivated due to the too high temperature of the solution, thereby avoiding the damage of the viscera of the donor 500.
In some embodiments, referring to fig. 1, the second circulation line 200 is further provided with a flow meter 270 and an oxygen blood monitor 280, the flow meter 270 being used to monitor the flow of blood in the first circulation line 100 or the second circulation line 200, and the oxygen blood monitor 280 being used to monitor the oxygen content of blood in the first circulation line 100 and the second circulation line 200. It should be noted that, since the second circulation line 200 is a part of the first circulation line 100, the flow meter 270 can monitor the blood flow (the blood flow refers to the amount of flowing blood per unit time (e.g., per minute)) on the second circulation line 200, and also can monitor the blood flow on the first circulation line 100, and the blood oxygen monitor 280 can monitor the oxygen content of the blood in the second circulation line 200, and also can monitor the oxygen content of the blood in the first circulation line 100.
Specifically, the upper and lower thresholds of the flow meter 270 and the blood oxygen monitor 280 may be preset, the blood flow and the blood oxygen content are allowed to fluctuate within a certain normal range, if the fluctuations of the blood flow and the blood oxygen content exceed the upper and lower thresholds of the flow meter 270 and the blood oxygen monitor 280, the flow meter 270 and the blood oxygen monitor 280 trigger an alarm to remind a medical staff to regulate and correct the blood flow and the blood oxygen content of the circulation pipeline, so that the blood flow and the blood oxygen content of the circulation pipeline are recovered to normal levels, for example, the blood flow in the circulation pipeline can be regulated through the blood pump 230, and the oxygen supply amount of the blood in the circulation pipeline can be regulated through the oxygenator 240. The flow meter 270 can accurately monitor the blood flow on the first circulation line 100 and the second circulation line 200, thereby accurately controlling the blood flow flowing to the internal organs of the donor 500, avoiding the impact on the internal organs caused by the overlarge blood flow flowing to the internal organs of the donor 500 from the first circulation line 100, and avoiding the failure to maintain the normal physiological activities of the internal organs caused by the overlarge blood flow flowing to the internal organs of the donor 500 from the first circulation line 100. The blood oxygen monitor 280 can accurately monitor the oxygen content of the blood in the first circulation line 100 and the second circulation line 200, so as to avoid oxygen poisoning of the viscera due to too high oxygen content in the blood flowing from the first circulation line 100 to the viscera in the donor 500, and avoid normal metabolic activity of the viscera due to too low oxygen content in the blood flowing from the first circulation line 100 to the viscera in the donor 500.
In some embodiments, referring to fig. 1, the second circulation line 200 is further provided with a bubble removal device 290 and a thrombus filtering device 291, wherein the bubble removal device 290 is used for removing bubbles in the blood circulation in the first circulation line 100 or the second circulation line 200, and the thrombus filtering device 291 is used for filtering out thrombus in the blood circulation in the first circulation line 100 or the second circulation line 200. Since the second circulation line 200 is a part of the first circulation line 100, the bubble removal device 290 can remove bubbles generated during the blood circulation in the second circulation line 200 and bubbles generated during the blood circulation in the first circulation line 100, and the thrombus filtering device 291 can filter out thrombus generated during the blood circulation in the second circulation line 200 and thrombus generated during the blood circulation in the first circulation line 100.
Specifically, by providing the air bubble removing device 290 and the thrombus filtering device 291 on the blood circulation line, air bubbles and thrombus in blood can be filtered, and the air bubbles and thrombus can be prevented from entering the viscera of the donor 500 to cause the blockage of the viscera, so that the normal flow of the blood is blocked, and the viscera can be further ensured to maintain normal physiological activities.
In some embodiments, referring to fig. 1, the blood reservoir 220 is provided with a second level sensor 221 and a second temperature sensor 222, the second level sensor 221 being for monitoring the level of blood in the blood reservoir 220 and the second temperature sensor 222 being for monitoring the temperature of blood in the blood reservoir 220.
Specifically, since the blood flowing into the donor 500 is supplied from the blood reservoir 220, in order to more directly and precisely monitor the temperature of the blood flowing into the donor 500, a sufficient blood supply amount is ensured in the blood reservoir 220, and the second liquid level sensor 221 and the second temperature sensor 222 are provided on the blood reservoir 220. When the blood content in the blood reservoir 220 is too low or too high, the second liquid level sensor 221 triggers an alarm to remind medical staff to timely fill blood into the blood reservoir 220 or stop filling blood, so that the blood is prevented from being delivered to the viscera in the donor 500 due to the too low blood content, the viscera is prevented from being damaged due to insufficient blood supply, or the blood is prevented from overflowing due to the too high blood content, and precious medical resources are prevented from being wasted. Similarly, when the temperature of the blood in the blood reservoir 220 is too low or too high, the second temperature sensor 222 triggers an alarm to remind the medical staff to heat or cool the blood in the blood reservoir 220 in time, so as to prevent the blood from failing to reach the designated temperature (generally about 37 ℃ and similar to the normal body temperature of the human body) due to the too low temperature of the blood, or prevent the active substances in the blood from being deactivated due to the too high temperature of the blood, thereby avoiding the damage of the viscera of the donor 500.
In some embodiments, the reservoir 220 is provided with a filling port for replenishing the reservoir 220 with blood. Specifically, the liquid filling port may be provided with a sealing ring, so as to ensure good sealing performance of the blood reservoir 220 when the blood reservoir 220 is not required to be replenished with blood, thereby avoiding the impurities in the air from entering the blood reservoir 220 and causing pollution to the blood.
In some embodiments, referring to fig. 1, the first circulation line 100 is provided with a pressure sensor 150 at an end thereof adjacent to the first connection end 110 for monitoring the blood pressure of the blood flowing into the donor 500 from the first circulation line 100. When the blood pressure is too low or too high, the pressure sensor 150 will trigger an alarm to remind the medical staff to adjust the blood pressure in time, prevent the blood from being unable to be normally supplied to the donor 500 due to the too low blood pressure, or prevent the viscera of the donor 500 from being impacted greatly due to the too high blood pressure, thereby ensuring the normal blood supply to the donor 500.
In some embodiments, referring to fig. 2, the system mechanisms in the present device, such as the blood pump 230, the oxygenator 240, the pinch-off valve, the heat exchanger 250, the hot water tank 260, the water pump 261, the sensor, the monitor, etc., are all connected to the same control circuit board 600, and the control circuit board 600 is connected with a touch display screen 700, so that after the device is powered on, each system parameter can be preset through the touch display screen 700 before the circulation line is started. The control circuit board 600 is also connected with an alarm 800, which triggers an alarm when any system mechanism in the device exceeds a preset system parameter threshold value, so as to ensure the safety of the device during operation.
Correspondingly, another embodiment of the present invention further provides a method for using a device for maintaining the organ activity of a heart-beat-free donor 500, referring to fig. 3, the method comprises the following steps:
Step S100, inserting the input tube 300 and the output tube 400 into the donor 500, so that the first circulation line 100, the input tube 300, the donor 500 and the output tube 400 form a closed blood circulation loop;
Specifically, the input tube 300 may be inserted into the femoral artery of the donor 500, and the output tube 400 may be inserted into the femoral vein of the donor 500.
Step 200, starting the device to enable the device to reach a pre-perfusion state;
Specifically, the first pinch-off valve 130 and the second pinch-off valve 140 are closed, the third pinch-off valve 210 is opened, and the heat exchanger 250 is heated by the hot water tank 260, heating is stopped when the water temperature in the hot water tank 260 reaches the set temperature, heating is started when the water temperature in the hot water tank 260 is lower than the set temperature, and the heating power of the hot water tank 260 is higher as the difference from the set lower temperature limit is larger. The flow rate of the system is monitored by the flow meter 270, and when the flow rate is lower than a set threshold, the rotational speed of the blood pump 230 is increased, and when the flow rate is higher than a preset threshold, the rotational speed of the blood pump 230 is decreased. The total gas flow and the air-to-oxygen ratio are set by the oxygenator 240, and the pre-perfusion state ignores the monitored value of the blood oxygen monitor 280, and is displayed only. Wherein, the value of the second temperature sensor 222 reaches the designated temperature (generally about 37 ℃ C., similar to the normal body temperature of human body), the rotation speed of the blood pump 230 is stable, and no air bubble appears in the circulation line, thus reaching the pre-perfusion state.
Step S300, after the physiological death of the donor 500, the device is rapidly switched from the pre-perfusion state to the formal perfusion state.
Specifically, the first pinch-off valve 130 and the second pinch-off valve 140 are opened, the third pinch-off valve 210 is closed, the liquid level of the blood in the blood reservoir 220 is monitored in real time through the second liquid level sensor 221, when the liquid level of the blood in the blood reservoir 220 is lower than a preset safety range, a medical staff is reminded to carry out liquid supplementation, when the liquid level of the blood in the blood reservoir 220 is lower than a warning limit value, the rotation speed of the blood pump 230 is immediately alarmed and reduced, the rotation speed of the blood pump 230 is automatically restored after the liquid level is restored to a normal range, and when the liquid level of the blood in the blood reservoir 220 is too rapidly reduced, the blood pump 230 is stopped and alarmed. The blood pressure and the blood flow rate in the circulation line are regulated by the blood pump 230, when the blood pressure is within a set range, the rotational speed of the blood pump 230 is determined by the blood flow rate, when the blood flow rate is lower than the set range, the rotational speed of the blood pump 230 is increased, when the blood flow rate is higher than the set range, the rotational speed of the blood pump 230 is decreased, when the blood pressure is lower than the set range, the rotational speed of the blood pump 230 is increased, and when the blood pressure is higher than the set range, the rotational speed of the blood pump 230 is decreased. The blood oxygen content in the circulating pipeline is monitored by the blood oxygen monitor 280, when the blood oxygen content is lower than a set value, the gas flow rate of the oxygenator 240 is gradually increased until the blood oxygen content reaches the standard, if the gas flow rate reaches the highest set value and the blood oxygen content still does not reach the standard, the oxygen proportion in the oxygenator 240 is gradually increased until the blood oxygen content reaches the standard, and if the blood oxygen content still does not reach the standard, an alarm prompts to replace the oxygenator 240.
In this embodiment, the method for using the device for maintaining the organ activity of the non-heart-beating donor 500 in this embodiment has the same technical effects as the device for maintaining the organ activity of the non-heart-beating donor 500 due to the improvement of the device for maintaining the organ activity of the non-heart-beating donor 500, and will not be repeated here.
It should be noted that, other contents of the device for maintaining the organ activity of the non-heart-beating donor 500 and the method for using the same disclosed in the present invention can be referred to the prior art, and are not repeated here.
The foregoing description of the preferred embodiments of the present invention should not be construed as limiting the scope of the invention, but rather should be understood to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the invention as defined by the following description and drawings or any application directly or indirectly to other relevant art(s).
Claims (8)
1. A device for maintaining the activity of an organ of a non-heart-beating donor for perfusing blood into the donor after physiological death of the donor to maintain the activity of the organ in the abdominal cavity of the donor, the device comprising:
The first circulating pipeline comprises a first connecting end part and a second connecting end part, a blood storage device, a blood pump and an oxygenator are arranged between the first connecting end part and the second connecting end part, the blood storage device is used for storing blood, the blood pump is used for providing power for the flow of the blood, and the oxygenator is used for realizing the air-blood exchange of the blood;
an input tube, one end of which is connected to the first connection end, and one end of which is away from the first connection end is connected to the femoral artery of the donor;
One end of the output tube is connected to the second connecting end part, and one end of the output tube, which deviates from the second connecting end part, is connected to the femoral vein of the donor;
wherein the descending aorta of the donor is preset with a blocking balloon which completely isolates the blood circulation between the thoracic cavity and the abdominal cavity of the donor, so as to ensure that the blood infused to the donor through the input tube circulates only in the abdominal cavity of the donor;
the first circulation pipeline, the input pipe, the donor and the output pipe form a closed blood circulation loop;
the first circulation line further includes:
the first pinch-off valve is arranged at one end, close to the first connecting end part, of the first circulating pipeline;
the second pinch-off valve is arranged at one end, close to the second connecting end part, of the first circulating pipeline;
The second circulation pipeline is arranged between the first pinch-off valve and the second pinch-off valve, comprises the blood reservoir, the blood pump and the oxygenator, and is provided with a third pinch-off valve;
When the first pinch-off valve and the second pinch-off valve are in an open state and the third pinch-off valve is in a closed state, blood circulation is realized in the first circulation pipeline, blood flows through the blood reservoir, the blood pump, the oxygenator and the donor, and when the first pinch-off valve and the second pinch-off valve are in a closed state and the third pinch-off valve is in an open state, blood circulation is realized in the second circulation pipeline, and blood flows through the blood reservoir, the blood pump and the oxygenator;
The second circulation pipeline is further provided with a heat exchanger, the heat exchanger is connected with a hot water tank, the hot water tank comprises a liquid inlet and a liquid outlet, the liquid inlet and the liquid outlet are communicated with the heat exchanger through pipelines, so that a solution in the hot water tank flows into the heat exchanger through the pipelines from the liquid outlet, and flows back to the hot water tank from the heat exchanger through the pipelines from the liquid inlet through the pipelines, and heat exchange of blood in the first circulation pipeline or the second circulation pipeline is realized;
The heat exchanger is used for adjusting the temperature of blood in the first circulation pipeline or the second circulation pipeline to 37 ℃.
2. The apparatus for maintaining the activity of heart beat-free donor organs of claim 1, wherein the pipe is provided with a water pump for increasing the flow rate of the solution in the hot water tank.
3. The device for keeping the heart beat-free donor organ activity according to claim 1, wherein the hot water tank is provided with a first level sensor for monitoring the level of the solution in the hot water tank and a first temperature sensor for monitoring the temperature of the solution in the hot water tank.
4. The device for maintaining the activity of a heart beat-free donor organ according to claim 1, wherein the second circulation line is further provided with a flow meter for monitoring the flow rate of blood in the first circulation line or the second circulation line and an blood oxygen monitor for monitoring the oxygen content of blood in the first circulation line and the second circulation line.
5. The device for keeping the heart beat-free donor organ activity according to claim 1, wherein the second circulation line is further provided with a bubble removing device for removing bubbles in the blood circulation in the first circulation line or the second circulation line and a thrombus filtering device for filtering out thrombus in the blood circulation in the first circulation line or the second circulation line.
6. The device for maintaining the activity of a heart beat-free donor organ according to claim 1, wherein the blood reservoir is provided with a second level sensor for monitoring the level of blood in the blood reservoir and a second temperature sensor for monitoring the temperature of blood in the blood reservoir.
7. The device for maintaining the activity of a heart beat-free donor organ of claim 1, wherein the blood reservoir is provided with a filling port for replenishing the blood reservoir with blood.
8. The device for maintaining the activity of an organ of a heart beat-free donor of any one of claims 1 to 7, wherein a pressure sensor is provided at an end of the first circulation line near the first connection end for monitoring the blood pressure of blood flowing from the first circulation line into the donor.
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