Insulin therapy in organ donation and transplantation.
Insulin therapy in organ donation and transplantation.
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器官捐献和移植中的胰岛素治疗。
DOI：
10.1111/dom.13728
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Shapey IM
中科院分区：
文献类型：
--
作者：
Shapey IM
高血糖症在住院患者中很常见，通常是由与危重疾病或大手术相关的生理应激引起的。胰岛素治疗是高钾血症和急性高钾血症的既定治疗方法，也已用于对正性肌力支持抵抗的心肌功能障碍。胰岛素通常用于器官捐献者和移植受者的高血糖症，但支持其使用的基础知识仍然有限。胰岛素治疗在器官捐献和移植中起着重要但知之甚少的作用。在过去的15年里，严格的血液控制在重症监护中得到了广泛的研究;然而，这还没有转化为移植领域，患者更不舒服，改善结果仍然是一个持续的挑战。胰岛素治疗和优化血液控制代表了未来器官捐献和移植研究的重要领域，如改善缺血再灌注损伤、排斥反应和感染。
Hyperglycaemia is common in hospitalized individuals, and is often caused by physiological stress associated with critical illness or major surgery. Insulin therapy is an established treatment for hyperglycaemia and acute hyperkalaemia, and has also been used for myocardial dysfunction resistant to inotropic support. Insulin is commonly used in both organ donors and transplant recipients for hyperglycaemia, but the underlying knowledge base supporting its use remains limited. Insulin therapy plays an important yet poorly understood role in both organ donation and transplantation. Tight glycaemic control has been extensively studied in critical care over the past 15 years; however, this has not yet translated into the field of transplantation, where patients are more unwell and where improved outcomes remain an ongoing challenge. Insulin therapy and optimization of glycaemic control represent important areas for future hypothesis‐driven research into organ donation and transplantation, such as amelioration of ischaemia‐reperfusion injury, rejection and infection.