The role of normothermic extracorporeal perfusion in minimizing ischemia reperfusion injury
The role of normothermic extracorporeal perfusion in minimizing ischemia reperfusion injury
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DOI：
10.1016/j.trre.2011.02.004
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发表时间：
2012-04-01
影响因子：
4
通讯作者：
Friend, Peter J.
中科院分区：
文献类型：
--
作者：
Vogel, Thomas;Brockmann, Jens G.;Friend, Peter J.
器官保存的主要目标是提供一个存活的移植物，并将术后移植物功能受损的风险降至最低。在目前的临床实践中，移植器官的保存是基于低温。器官用特定的保存溶液冲洗和储存，以减少细胞新陈代谢，防止细胞肿胀。然而，器官捐赠者持续短缺以及随之而来的捐赠者标准扩大到包括使用曾经被认为不合适而被丢弃的移植物，突显了需要一种技术来防止在保存期内的任何进一步损害。常温机器灌流保存的原理是在整个保存期内维持生理环境中的细胞新陈代谢。因此，至少在理论上，常温保存通过(1)避免缺血/再灌注损伤，(2)避免冷损伤，(3)允许进行活性评估，从而克服了传统静态冷藏固有的三大缺点。此外，常温机器灌流可能是在保存期间提供其他治疗干预的理想载体，以在移植前调节和优化移植物。通过恢复边缘供体器官的功能并使临床医生能够评估其生存能力，供体池可能会大大扩大。(C)2012 Elsevier Inc.保留所有权利。
The primary objective of organ preservation is to deliver a viable graft with minimal risk of impaired postoperative graft function. In current clinical practice, preservation of transplanted organs is based on hypothermia. Organs are flushed and stored using specific preservation solutions to reduce cellular metabolism and prevent cell swelling. However, the ongoing organ donor shortage and consequent expansion of donor criteria to include the use of grafts that would once have been discarded as unsuitable have underlined the need for a technique that prevents any further damage during the preservation period. The principle of normothermic machine perfusion preservation is the maintenance of cellular metabolism in a physiological environment throughout the preservation period. Normothermic preservation, at least in theory, thereby overcomes the 3 major weaknesses inherent in traditional static cold storage by (1) avoiding ischemia/reperfusion injury, (2) avoiding cold injury, and (3) allowing viability assessment. Furthermore, normothermic machine perfusion might transpire to be the ideal vehicle to deliver other therapeutic interventions during preservation to modulate and optimize the graft before transplantation. By restoring function in marginal donor organs and enabling the clinician to appraise its viability, the donor pool might be greatly expanded. (C) 2012 Elsevier Inc. All rights reserved.