Revisiting the Principles of Preservation in an Era of Pandemic Obesity.
Revisiting the Principles of Preservation in an Era of Pandemic Obesity.
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DOI：
10.3389/fimmu.2022.830992
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发表时间：
2022
影响因子：
7.3
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中科院分区：
文献类型：
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目前的肥胖症流行已经导致我们的捐赠人群的健康状况显著下降。来自肥胖死亡供体的器官更容易因器官保存而发生缺血再灌注损伤。因此，这些捐赠者更有可能被丢弃的假设下，没有什么可以做，使他们可行的移植。我们目前的器官移植方法在过去的40年里保持相对不变，最初是在一个更健康的供体群体的背景下采用的。但是，适合健康的已故捐赠者的方法可能不适合肥胖捐赠者的器官。自然发生的急性肥胖和禁食冬眠哺乳动物模型表明，肥胖和恢复能力冷解冻样条件是不是相互排斥的。此外，我们对肥胖症背后的代谢功能障碍的理解的最新进展表明，有可能提高肥胖已故捐赠者器官的弹性。在这篇简短的综述中，我们将探讨如何调整我们目前的器官保存实践，以更好地适应我们已故供体群体的现实。
The current obesity epidemic has caused a significant decline in the health of our donor population. Organs from obese deceased donors are more prone to ischemia reperfusion injury resulting from organ preservation. As a consequence, these donors are more likely to be discarded under the assumption that nothing can be done to make them viable for transplant. Our current methods of organ preservation—which remain relatively unchanged over the last ~40 years—were originally adopted in the context of a much healthier donor population. But methods that are suitable for healthier deceased donors are likely not optimal for organs from obese donors. Naturally occurring models of acute obesity and fasting in hibernating mammals demonstrate that obesity and resilience to cold preservation-like conditions are not mutually exclusive. Moreover, recent advances in our understanding of the metabolic dysfunction that underlies obesity suggest that it may be possible to improve the resilience of organs from obese deceased donors. In this mini-review, we explore how we might adapt our current practice of organ preservation to better suit the current reality of our deceased donor population.