Challenges in machine perfusion preservation for liver grafts from donation after circulatory death.
Challenges in machine perfusion preservation for liver grafts from donation after circulatory death.
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DOI：
10.1186/2047-1440-2-19
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发表时间：
2013-11-27
期刊：
影响因子：
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通讯作者：
Kobayashi E
中科院分区：
文献类型：
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作者：
Matsuno N;Kobayashi E
循环死亡后捐献（DCD）是解决供体移植组织严重短缺的一个有前途的解决方案。在捐献后维持器官活力直到移植对于最佳的移植物功能和存活是必不可少的。迄今为止，静态冷藏是临床实践中最广泛使用的保存形式。然而，DCD移植物中存在的缺血性损伤在冷藏过程中危及器官活力，静态冷藏是否是防止DCD器官数量增加时器官质量恶化的最有效方法尚不清楚。在这里，我们描述了DCD肝移植的历史背景和一种新的实验和临床移植的保存方法。为了防止DCD肝移植的缺血-再灌注损伤，最近发展了低温机器灌注（HMP）技术，该技术可能上级静态冷保存。我们目前的证据支持需要改善肝脏灌注性能，并讨论如何这样做将有利于肝移植受者。
Donation after circulatory death (DCD) is a promising solution to the critical shortage of donor graft tissue. Maintaining organ viability after donation until transplantation is essential for optimal graft function and survival. To date, static cold storage is the most widely used form of preservation in clinical practice. However, ischemic damage present in DCD grafts jeopardizes organ viability during cold storage, and whether static cold storage is the most effective method to prevent deterioration of organ quality in the increasing numbers of organs from DCD is unknown. Here we describe the historical background of DCD liver grafts and a new preservation method for experimental and clinical transplantation. To prevent ischemia-reperfusion injury in DCD liver grafts, a hypothermic machine perfusion (HMP) technique has recently been developed and may be superior to static cold preservation. We present evidence supporting the need for improving liver perfusion performance and discuss how doing so will benefit liver transplantation recipients.