Xenogeneic cross-circulation for physiological support and recovery of ex vivo human livers.
Xenogeneic cross-circulation for physiological support and recovery of ex vivo human livers.
复制标题
DOI：
10.1097/hep.0000000000000357
复制
发表时间：
2023-09-01
期刊：
影响因子：
13.5
通讯作者：
Bacchetta, Matthew
中科院分区：
文献类型：
--
作者：
Wu, Wei Kelly;Ukita, Rei;Patel, Yatrik J.;Cortelli, Michael;Trinh, Vincent Q.;Ziogas, Ioannis A.;Francois, Sean A.;Mentz, Meredith;Cardwell, Nancy L.;Talackine, Jennifer R.;Grogan, William M.;Stokes, John W.;Lee, Youngmin A. A.;Kim, Jinho;Alexopoulos, Sophoclis P.;Bacchetta, Matthew
合适的供体肝脏的稀缺突显了在肝移植中持续需要创新来恢复具有可逆性损伤的器官。移植的人供肝(n=5)采用异种全血在肝脏和异种支持猪之间的交叉循环来支持。对肝脏和猪进行了24小时的异种支持评估。肝脏保持了正常的整体外观，均匀的血流灌注，以及组织学和亚细胞结构的保存。耗氧量增加75%(p=0.16)。乳酸清除率从−的0.4±15.5%增加到31.4±19.0%(p=0.02)。盲法组织病理学评估显示，与12小时相比，24小时的损伤评分有所改善。保留了血管的完整性和收缩功能。所有肝脏的胆汁体积和胆管细胞活性标记物均有所改善。保持了胆管结构的完整性。异种交叉循环为体外人体肝脏提供了多系统的生理调节，使功能恢复、组织病理学恢复和生存标记物的改善成为可能。我们设想异种交叉循环作为其他器官保存技术在边缘供体肝脏回收方面的补充技术，或作为开发先进的生物工程和药理学策略的研究工具，用于器官恢复和康复。
The scarcity of suitable donor livers highlights a continuing need for innovation to recover organs with reversible injuries in liver transplantation. Explanted human donor livers (n = 5) declined for transplantation were supported using xenogeneic cross-circulation of whole blood between livers and xeno-support swine. Livers and swine were assessed over 24 hours of xeno-support. Livers maintained normal global appearance, uniform perfusion, and preservation of histologic and subcellular architecture. Oxygen consumption increased by 75% (p = 0.16). Lactate clearance increased from −0.4 ± 15.5% to 31.4 ± 19.0% (p = 0.02). Blinded histopathologic assessment demonstrated improved injury scores at 24 hours compared with 12 hours. Vascular integrity and vasoconstrictive function were preserved. Bile volume and cholangiocellular viability markers improved for all livers. Biliary structural integrity was maintained. Xenogeneic cross-circulation provided multisystem physiological regulation of ex vivo human livers that enabled functional rehabilitation, histopathologic recovery, and improvement of viability markers. We envision xenogeneic cross-circulation as a complementary technique to other organ-preservation technologies in the recovery of marginal donor livers or as a research tool in the development of advanced bioengineering and pharmacologic strategies for organ recovery and rehabilitation.
DOI：
10.1111/j.1600-6143.2008.02337.x
发表时间：
2008-09
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：
Kiernan K;Harnden I;Gunthart M;Gregory C;Meisner J;Kearns-Jonker M
通讯作者：
Kearns-Jonker M
影响因子：
3.9
作者：
Li Q;Hara H;Zhang Z;Breimer ME;Wang Y;Cooper DKC
通讯作者：
Cooper DKC