vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2024-1-130-139vtio-1725Research ArticleДонорство органовOrgan DonationНеконтролируемые доноры органов с внегоспитальной остановкой кровообращения. Обзор литературыUncontrolled organ donation after out-of-hospital cardiac arrest. Literature reviewМининаМ. Г.MininaM. G.

125284, Москва, 2-й Боткинский пр-д, 5. 

5, Vtoroy Botkinskiy Proyezd, Moscow, 125284

ДроздовП. А.DrozdovP. A.

125284, Москва, 2-й Боткинский пр-д, 5. 

5, Vtoroy Botkinskiy Proyezd, Moscow, 125284

СевостьяновВ. М.SevostyanovV. M.

125284, Москва, 2-й Боткинский пр-д, 5. 

5, Vtoroy Botkinskiy Proyezd, Moscow, 125284

ТенчуринаЭ. А.TenchurinaE. A.

125284, Москва, 2-й Боткинский пр-д, 5. 

5, Vtoroy Botkinskiy Proyezd, Moscow, 125284

arimle@inbox.ruНевредимовА. А.NevredimovA. A.

125284, Москва, 2-й Боткинский пр-д, 5. 

5, Vtoroy Botkinskiy Proyezd, Moscow, 125284

ДавыдовП. А.DavydovP. A.

Москва

Moscow

ШацковаО. В.ShatskovaO. V.

Москва

Moscow

ГБУЗ «Городская клиническая больница имени С.П. Боткина Департамента здравоохранения города Москвы», Московский городской координационный центр органного донорстваРоссияBotkin HospitalRussian FederationГБУ города Москвы «Станция скорой и неотложной медицинской помощи имени А.С. Пучкова Департамента здравоохранения города Москвы»РоссияPuchkov Ambulance and Emergency Medical Care StationRussian Federation202415012024261130139Copyright © Минина М.Г., Дроздов П.А., Севостьянов В.М., Тенчурина Э.А., Невредимов А.А., Давыдов П.А., Шацкова О.В., 20242024Минина М.Г., Дроздов П.А., Севостьянов В.М., Тенчурина Э.А., Невредимов А.А., Давыдов П.А., Шацкова О.В.Minina M.G., Drozdov P.A., Sevostyanov V.M., Tenchurina E.A., Nevredimov A.A., Davydov P.A., Shatskova O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1725

Трансплантация органов является эффективным методом лечения пациентов с терминальной стадией органной недостаточности. Глобальное развитие трансплантации органов как вида медицинской помощи неразрывно связано с утверждением неврологических критериев констатации смерти человека (смерти головного мозга). В раннем эволюционном периоде трансплантации использовались органы, преимущественно почки, полученные от доноров, чья смерть констатировалась в соответствии с общепринятыми критериями прекращения кровообращения и дыхания. По мере развития данного вида донорства органов в мировой литературе использовались многочисленные термины для его обозначения – асистолические доноры (asystolic donors), доноры с небьющимся сердцем (non-heart beating donors), доноры с сердечной смертью (donors after cardiac death) и т. д. В России существует устоявшаяся практика работы с донорами после остановки кровообращения, но активное развитие российской трансплантологии в последние 20 лет сопряжено прежде всего с донорством органов после констатации смерти головного мозга. Вместе с тем страны с наиболее активными и совершенными практиками донорства органов в последние годы успешно работают с донорами, у которых наступила внезапная остановка кровообращения во внегоспитальных условиях. Ранее такой вид донорства рассматривался как недоступный ввиду неприемлемых сроков тепловой ишемии, и соответственно, тяжелого повреждения донорских органов. В связи с развитием новых технологий в оказании экстренной медицинской помощи стало возможным обеспечить транспортировку пациента с клинической смертью, наступившей во внегоспитальных условиях, в стационар, обеспечивая при этом сердечно-легочную реанимацию посредством устройства автоматической компрессии грудной клетки и искусственной вентиляции легких. В статье приведены исторические аспекты донорства органов после остановки кровообращения и наиболее актуализированные определения и практики работы с такими донорами.

Organ transplantation is the best therapy for terminal and irreversible organ failure. The global development of organ transplantation as a type of medical care is inextricably linked to the establishment of neurological criteria for declaring human death (brain death). In the early evolutionary period of transplantation, organs were used, mainly kidneys, obtained from donors whose death was ascertained in accordance with the generally accepted criteria of cessation of blood circulation and respiration. As this type of organ donation developed, numerous terms were used in the world literature to designate it, such as ‘asystolic donors’, ‘non-heart beating donors’, ‘donors after cardiac death’, etc. In Russia, there is an established practice of dealing with donors after cardiac death (DCD), but the active development of Russian transplantology in the last 20 years is primarily associated with brain-dead organ donation. However, countries with the most active and advanced organ donation practices have in recent years been successfully dealing with donors who have suffered sudden out-of-hospital cardiac arrest (OHCA). Previously, this type of donation was considered inaccessible due to the unacceptable warm ischemia time and consequently severe damage to donor organs. Due to the development of new technologies in emergency medical care, it became possible to transport a patient with clinical death that occurred in an outof-hospital setting, to the hospital, while providing cardiopulmonary resuscitation by means of automatic chest compression and artificial ventilation. The article presents historical aspects of donation after cardiac death, and the most actualized definitions and practices of dealing with such donors.

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The authors declare that there are no conflicts of interest present.