Liver transplantation after organ preservation with normothermic extracorporeal perfusion
Liver transplantation after organ preservation with normothermic extracorporeal perfusion
复制标题
DOI：
10.1097/00000658-200101000-00017
复制
发表时间：
2001-01-01
影响因子：
9
通讯作者：
Neuhaus, P
中科院分区：
文献类型：
--
作者：
Schön, MR;Kollmar, O;Neuhaus, P
目的研究常温体外肝脏灌注（NELP）作为保存移植肝脏和逆转热缺血性损伤的一种手段。背景资料摘要作者提供的实验证据表明，常温体外肝脏灌注 4 小时后成功移植是可能的，并且与威斯康星大学溶液冷保存 4 小时一样可靠。 NELP完全保留了肝功能，可以逆转无心跳供体60分钟的热缺血性损伤。方法将36头德国长白猪分为6组，接受移植。第1组动物接受直接移植。第 2 组动物在用威斯康星大学溶液冷藏 4 小时后接受移植，第 3 组动物在 NELP 4 小时后接受移植。第4组动物在移植前持续1小时的热缺血。第5组动物在1小时热缺血和4小时冷藏后接受移植，第6组动物在1小时热缺血和4小时NELP后接受移植。结果所有接受NELP处理肝脏的动物在移植后存活超过7天（第3组和第6组），相比之下，第5组中的所有动物在移植后24小时内出现原发性移植物无功能。结论 NELP技术具有保留哺乳动物肝脏的潜力体外功能完全正常，可能持续4个多小时。 NELP 可用于移植前的肝脏保存或使用无心跳供体的器官。
ObjectiveTo study normothermic extracorporeal liver perfusion (NELP) as a means to preserve livers for transplantation and to reverse warm ischemic injury.Summary Background DataThe authors provide experimental evidence that successful transplantation after 4 hours of normothermic extracorporeal liver perfusion is possible and as reliable as 4 hours of cold preservation in University of Wisconsin solution. NELP preserves liver function completely and can reverse 60 minutes of warm ischemic injury in non-heart-beating donors.MethodsThirty-six German Landrace pigs received transplants in six groups. Group 1 animals received direct transplantation. Group 2 received transplants after 4 hours of cold preservation with University of Wisconsin solution and Group 3 animals after 4 hours of NELP. Group 4 animals sustained 1 hour of warm ischemia before transplantation. Group 5 animals received transplants after 1 hour of warm ischemia and 4 hours of cold preservation and Group 6 animals after 1 hour of warm ischemia and 4 hours of NELP.ResultsAll animals receiving livers treated by NELP survived more than 7 days after the transplant (Groups 3 and 6), in contrast, all animals in Group 5 developed primary graft nonfunction within 24 hours after transplantation.ConclusionThe technique of NELP holds the potential to keep a mammalian liver outside the body completely functional, possibly for more than 4 hours. NELP can be used for liver preservation before transplantation or for the use of organs from non-heart-beating donors.