附錄 B — 附錄 B. 器官摘取設備清單 / Appendix B. Organ Procurement Equipment Checklist
版本： 草稿 v0.1 | 📋 需由三總移植團隊確認並補充
Version: Draft v0.1 | 📋 Requires review and supplementation by the TSGH transplant team
B.1 B.1 出發前 Checklist / B.1 Pre-Departure Checklist
B.1.1 文件與通訊 / Documents and Communication
| 項目 | ✓ |
|---|---|
| 捐贈者資料（ID、血型、身高體重、CMV 狀態） | □ |
| 配對確認文件 | □ |
| 同意書影本 | □ |
| 團隊聯絡電話清單 | □ |
| 手術排程確認（受贈者端） | □ |
| 交通安排確認（航班/高鐵/救護車） | □ |
| Item | ✓ | |—|—| | Donor information (ID, blood type, height/weight, CMV status) | □ | | Matching confirmation documents | □ | | Copy of consent form | □ | | Team contact phone list | □ | | Surgical scheduling confirmation (recipient side) | □ | | Transportation arrangement confirmation (flight/high-speed rail/ambulance) | □ |
B.1.2 保存液與灌流 / Preservation Solution and Perfusion
| 項目 | 數量 | ✓ |
|---|---|---|
| Perfadex（低鉀右旋糖苷液） | 4-6 L | □ |
| Prostaglandin E1（Alprostadil） | 500 μg（加入灌流液） | □ |
| 冰（crushed ice） | 充足 | □ |
| 無菌冰水 | 充足 | □ |
| 器官保存袋（triple bag） | 2 套 | □ |
| 保冷箱（cooler） | 1-2 個 | □ |
| 溫度監測器 | 1 | □ |
| Item | Quantity | ✓ | |—|—|—| | Perfadex (low-potassium dextran solution) | 4-6 L | □ | | Prostaglandin E1 (Alprostadil) | 500 μg (added to perfusion solution) | □ | | Ice (crushed ice) | Sufficient | □ | | Sterile ice water | Sufficient | □ | | Organ preservation bags (triple bag) | 2 sets | □ | | Cooler | 1-2 | □ | | Temperature monitor | 1 | □ |
B.1.3 手術器械 / Surgical Instruments
| 項目 | 數量 | ✓ |
|---|---|---|
| 開胸器械組 | 1 套 | □ |
| Sternal saw / Sternotomy set | 1 套 | □ |
| 長血管鉗（大） | 2-4 支 | □ |
| 剪刀（Metzenbaum, Mayo） | 各 2 支 | □ |
| 手術刀片 (#10, #15) | 各 5 片 | □ |
| 電燒（monopolar） | 1 | □ |
| Satinsky clamp | 1-2 支 | □ |
| TA stapler（支氣管用） | 1 | □ |
| 吸引管 | 2 | □ |
| Item | Quantity | ✓ | |—|—|—| | Thoracotomy instrument set | 1 set | □ | | Sternal saw / Sternotomy set | 1 set | □ | | Long vascular clamps (large) | 2-4 | □ | | Scissors (Metzenbaum, Mayo) | 2 each | □ | | Scalpel blades (#10, #15) | 5 each | □ | | Electrocautery (monopolar) | 1 | □ | | Satinsky clamp | 1-2 | □ | | TA stapler (for bronchus) | 1 | □ | | Suction cannula | 2 | □ |
B.1.4 縫線與耗材 / Sutures and Supplies
| 項目 | 數量 | ✓ |
|---|---|---|
| Prolene 4-0（肺動脈/肺靜脈） | 4 | □ |
| 紗布（4x4） | 1 包 | □ |
| 手術巾 | 足量 | □ |
| 無菌手套（各尺寸） | 足量 | □ |
| 無菌手術衣 | 足量 | □ |
| 引流管（胸管） | 預備 | □ |
| Item | Quantity | ✓ | |—|—|—| | Prolene 4-0 (pulmonary artery/vein) | 4 | □ | | Gauze (4x4) | 1 pack | □ | | Surgical drapes | Sufficient | □ | | Sterile gloves (assorted sizes) | Sufficient | □ | | Sterile surgical gowns | Sufficient | □ | | Drain tubes (chest tubes) | On standby | □ |
B.1.5 灌流設備 / Perfusion Equipment
| 項目 | 數量 | ✓ |
|---|---|---|
| 灌流 cannula（pulmonary artery） | 1 | □ |
| Retrograde flush cannula（肺靜脈） | 1 | □ |
| Y-connector | 1 | □ |
| IV tubing / perfusion tubing | 2 套 | □ |
| 三向活栓 | 2-3 | □ |
| Item | Quantity | ✓ | |—|—|—| | Perfusion cannula (pulmonary artery) | 1 | □ | | Retrograde flush cannula (pulmonary vein) | 1 | □ | | Y-connector | 1 | □ | | IV tubing / perfusion tubing | 2 sets | □ | | Three-way stopcock | 2-3 | □ |
B.1.6 其他 / Miscellaneous
| 項目 | 數量 | ✓ |
|---|---|---|
| 手電筒 / 頭燈 | 1 | □ |
| 標本袋（組織/培養） | 數個 | □ |
| 培養試管（好氧/厭氧） | 各 2 | □ |
| 標籤（左肺/右肺） | 2 | □ |
| 相機 / 手機（記錄用） | 1 | □ |
| Item | Quantity | ✓ | |—|—|—| | Flashlight / headlamp | 1 | □ | | Specimen bags (tissue/culture) | Several | □ | | Culture tubes (aerobic/anaerobic) | 2 each | □ | | Labels (left lung/right lung) | 2 | □ | | Camera / mobile phone (for documentation) | 1 | □ |
B.2 B.2 Back Table 準備 / B.2 Back Table Preparation
| 步驟 | 說明 | ✓ |
|---|---|---|
| 確認左右肺標記 | 避免混淆 | □ |
| 檢查肺實質 | 外觀、挫傷、結節 | □ |
| Retrograde flush | Perfadex 經肺靜脈逆行灌流 | □ |
| 修剪 | PA、PV、bronchus cuff | □ |
| 培養 | 支氣管分泌物送培養 | □ |
| 紀錄 | 冷缺血時間起始 | □ |
| Step | Description | ✓ | |—|—|—| | Confirm left/right lung labeling | Prevent misidentification | □ | | Inspect lung parenchyma | Appearance, contusions, nodules | □ | | Retrograde flush | Perfadex via pulmonary vein retrograde perfusion | □ | | Trimming | PA, PV, bronchus cuff | □ | | Culture | Bronchial secretion for culture | □ | | Documentation | Record cold ischemia time onset | □ |
B.3 B.3 冷缺血時間管理 / B.3 Cold Ischemia Time Management
| 階段 | 紀錄 |
|---|---|
| Cross-clamp 時間 | : |
| 灌流開始時間 | : |
| 灌流結束時間 | : |
| 離開捐贈者醫院 | : |
| 抵達三總 | : |
| 第一肺再灌注 | : |
| 第二肺再灌注 | : |
| 總冷缺血時間 | _h _min |
| Phase | Record | |—|—| | Cross-clamp time | : | | Perfusion start time | : | | Perfusion end time | : | | Departure from donor hospital | : | | Arrival at TSGH | : | | First lung reperfusion | : | | Second lung reperfusion | : | *| Total cold ischemia time | _h _min |*
⚠️ 目標冷缺血時間 < 6 小時；> 8 小時 PGD 風險顯著上升
⚠️ Target cold ischemia time < 6 hours; PGD risk increases significantly when > 8 hours
B.4 B.4 緊急聯絡 / B.4 Emergency Contacts
📋 需填入三總團隊聯絡資訊：
📋 TSGH team contact information to be filled in:
| 角色 | 姓名 | 電話 |
|---|---|---|
| 主刀醫師 | __________ | __________ |
| 摘取外科醫師 | __________ | __________ |
| 移植協調師 | __________ | __________ |
| 麻醉科 | __________ | __________ |
| ICU 值班 | __________ | __________ |
| 器官勸募中心 | __________ | __________ |
| Role | Name | Phone | |—|—|—| | Lead surgeon | __________ | __________ | | Procurement surgeon | __________ | __________ | | Transplant coordinator | __________ | __________ | | Anesthesiology | __________ | __________ | | ICU on-call | __________ | __________ | | Organ procurement center | __________ | __________ |
📋 此清單需由三總移植團隊根據實際設備與流程審閱修訂。
📋 This checklist requires review and revision by the TSGH transplant team based on actual equipment and procedures.