First in Man Renal Transplantation After Ex Vivo Normothermic Perfusion
First in Man Renal Transplantation After Ex Vivo Normothermic Perfusion
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DOI：
10.1097/tp.0b013e31822d4e04
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发表时间：
2011-10-15
期刊：
影响因子：
6.2
通讯作者：
Nicholson, Michael L.
中科院分区：
文献类型：
--
作者：
Hosgood, Sarah A.;Nicholson, Michael L.
背景常温灌注是一种替代的但研究较少的器官保存方法。在此，我们报告了第一例离体常温肾移植灌注的人。这位62岁的扩展标准供体死于颅内出血，并因心脏骤停30分钟而接受了心肺复苏。静态冷藏11小时后，移植前立即将左肾在平均温度33.9 ℃下用不含血浆的红细胞溶液灌注35分钟。离体灌注回路由离心泵、膜式氧合器和热交换器组成。将配对的右肾静态冷藏14 h。移植后，55岁的女性受体的常温灌注肾移植功能缓慢，但患者保持透析独立;血清肌酐在3个月后移植是132 μ mol/L。将成对的静态冷藏肾移植到一名52岁的男性受体体内。该肾移植后功能延迟26天，3个月血清肌酐为218 μ mol/L。我们的结论是，离体常温肾脏灌注与无血浆红细胞为基础的解决方案是一种可行的方法保存。这第一例手术在不损害移植肾的情况下进行。
Background. Normothermic perfusion is an alternative but little studied method of organ preservation. Herein, we report the first case of ex vivo normothermic renal transplant perfusion in man.Methods. The 62-year-old extended criteria donor died of an intracranial hemorrhage and had undergone cardiopulmonary resuscitation for a 30-min cardiac arrest. After 11 hr of static cold storage and immediately before transplantation, the left kidney was perfused at a mean temperature of 33.9 degrees C for 35 min with a plasma-free red cell-based solution. The ex vivo perfusion circuit consisted of a centrifugal pump, a membrane oxygenator, and a heat exchanger. The paired right kidney underwent static cold storage for 14 hr.Results. After transplantation, the 55-year-old female recipient of the normothermic perfused kidney had slow graft function but the patient remained dialysis independent; serum creatinine at 3 months posttransplant was 132 mu mol/L. The paired static cold-stored kidney was transplanted into a 52-year-old male recipient. This kidney had delayed graft function for a period of 26 days, and the 3-month serum creatinine was 218 mu mol/L.Conclusion. We conclude that ex vivo normothermic kidney perfusion with a plasma-free red cell-based solution is a feasible method of preservation. This first case was performed without compromising the transplant kidney.