Renal Transplantation After Ex Vivo Normothermic Perfusion: The First Clinical Study
Renal Transplantation After Ex Vivo Normothermic Perfusion: The First Clinical Study
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DOI：
10.1111/ajt.12179
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发表时间：
2013-05-01
影响因子：
8.8
通讯作者：
Hosgood, S. A.
中科院分区：
文献类型：
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作者：
Nicholson, M. L.;Hosgood, S. A.
离体常温灌注（EVNP）是一种新的保存方法，可在移植前恢复循环并使器官恢复功能。本研究的目的是评估EVNP在边缘供体肾脏中的作用。来自扩展标准供体（ECD）的18个肾脏在移植前立即进行了一段时间的EVNP。在34.6 ℃的平均温度下，用基于无血浆红细胞的溶液灌注肾脏。将这些肾脏的结果与进行静态冷藏（CS）的47个ECD肾脏的对照组进行比较。EVNP组的平均供体年龄为61 ± 1岁，CS组为62 ± 6岁（p = 0.520）。EVNP肾平均灌注63 +/-16分钟，全部成功移植。移植肾功能延迟恢复率（DGF）定义为前7天内需要透析，EVNP组为1/18例患者（5.6%），CS组为17/47例患者（36.2%）（p = 0.014）。12个月时移植物或患者存活率无差异（p = 0.510，1.000）。第一个系列的EVNP在肾移植中的应用表明，这种技术是可行的和安全的。我们的初步数据表明，EVNP作为一种新的肾脏保存技术提供了希望。
Ex vivo normothermic perfusion (EVNP) is a novel method of preservation that restores circulation and allows an organ to regain function prior to transplantation. The aim of this study was to assess the effects of EVNP in kidneys from marginal donors. Eighteen kidneys from extended criteria donors (ECD) underwent a period of EVNP immediately before transplantation. Kidneys were perfused with a plasma free red-cell based solution at a mean temperature of 34.6 degrees C. The outcome of these kidneys was compared to a control group of 47 ECD kidneys that underwent static cold storage (CS). The mean donor age was 61 +/- 1years in the EVNP and 62 +/- 6years in the CS group (p= 0.520). EVNP kidneys were perfused for an average of 63 +/- 16min and all were transplanted successfully. The delayed graft function rate (DGF), defined as the requirement for dialysis within the first 7 days was 1/18 patients (5.6%) in the EVNP group versus 17/47 (36.2%) in the CS group (p= 0.014). There was no difference in graft or patient survival at 12months (p= 0.510, 1.000). This first series of EVNP in renal transplantation demonstrates that this technique is both feasible and safe. Our preliminary data suggests that EVNP offers promise as a new technique of kidney preservation.