From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies.
From Haphazard to a Sustainable Normothermic Regional Perfusion Service: A Blueprint for the Introduction of Novel Perfusion Technologies.
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DOI：
10.3389/ti.2022.10493
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发表时间：
2022
影响因子：
3.1
通讯作者：
Oniscu, Gabriel C.
中科院分区：
文献类型：
--
作者：
Hunt, Fiona;Johnston, Chris J. C.;Coutts, Lesley;Sherif, Ahmed E.;Farwell, Lynsey;Stutchfield, Ben M.;Sewpaul, Avi;Sutherland, Andrew;Babu, Benoy I.;Currie, Ian S.;Oniscu, Gabriel C.
关键词：
常温局部灌注（NRP）已显示出令人鼓舞的临床结果。然而，从实验到常规程序的转换带来了一些挑战。在这里，我们描述了一个模型，导致NRP的实施到标准的临床实践中，在我们的中心后，迭代的过程中，细化，包括培训，人员配备和操作技术。使用这种方法，我们在12个月内实现了训练有素的手术人员增加了4倍，合格的高级器官保存从业人员增加了6倍，覆盖了93%的检索电话。我们现在在英国各地定期提供NRP，并参加了186次NRP检索，其中225个肾脏，26个胰腺和61个肝脏已被移植，其中包括5个最初被所有英国移植中心拒绝。在长达8年的随访中，61例DCD（NRP）肝移植患者未出现原发性无功能或缺血性胆管病。此方法亦成功实施非原位常温肝脏灌注，连同NRP于二零二一年贡献37. 5%的肝脏移植活动。灌注技术（原位和异位）现在由高级灌注和器官保存专家团队提供支持。将新型灌注技术引入常规临床实践带来了重大挑战，但通过制定一个由强大的教育，培训和招聘计划支持的高级灌注和器官保存专家的特定角色，可以大大促进这一挑战。
Normothermic Regional Perfusion (NRP) has shown encouraging clinical results. However, translation from an experimental to routine procedure poses several challenges. Herein we describe a model that led to the implementation of NRP into standard clinical practice in our centre following an iterative process of refinement incorporating training, staffing and operative techniques. Using this approach we achieved a four-fold increase in trained surgical staff and a 6-fold increase in competent senior organ preservation practitioners in 12 months, covering 93% of the retrieval calls. We now routinely provide NRP throughout the UK and attended 186 NRP retrievals from which 225 kidneys, 26 pancreases and 61 livers have been transplanted, including 5 that were initially declined by all UK transplant centres. The 61 DCD(NRP) liver transplants undertaken exhibited no primary non-function or ischaemic cholangiopathy with up to 8 years of follow-up. This approach also enabled successful implementation of ex situ normothermic liver perfusion which together with NRP contributed 37.5% of liver transplant activity in 2021. Perfusion technologies (in situ and ex situ) are now supported by a team of Advanced Perfusion and Organ Preservation Specialists. The introduction of novel perfusion technologies into routine clinical practice presents significant challenges but can be greatly facilitated by developing a specific role of Advanced Perfusion and Organ Preservation Specialist supported by a robust education, training and recruitment programme.
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影响因子：
8.8
作者：
Oniscu, G. C.;Randle, L. V.;Watson, C. J. E.
通讯作者：
Watson, C. J. E.
影响因子：
8.8
作者：
Parent, Brendan;Moazami, Nader;Caplan, Arthur
通讯作者：
Caplan, Arthur
DOI：
10.1111/ajt.15775
发表时间：
2020-08
期刊：
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
影响因子：
--
作者：
Manara A;Shemie SD;Large S;Healey A;Baker A;Badiwala M;Berman M;Butler AJ;Chaudhury P;Dark J;Forsythe J;Freed DH;Gardiner D;Harvey D;Hornby L;MacLean J;Messer S;Oniscu GC;Simpson C;Teitelbaum J;Torrance S;Wilson LC;Watson CJE
通讯作者：
Watson CJE
影响因子：
2.3
作者：
Goussous N;Alvarez-Casas J;Dawany N;Xie W;Malik S;Gray SH;Barth RN;LaMattina JC
通讯作者：
LaMattina JC
DOI：
10.1093/bjs/znab212
发表时间：
2021-12-01
期刊：
The British journal of surgery
影响因子：
--
作者：
Richards JA;Roberts JL;Fedotovs A;Paul S;Cottee S;Defries G;Watson CJE;Pettigrew GJ
通讯作者：
Pettigrew GJ