LONG-TERM ORGAN PRESERVATION FOR TRANPLANTATION

本研究的目的是开发一种安全可靠的技术 用于长期保存移植器官。 器官移植已被证明在治疗 终末期器官衰竭的患者。 这些程序的适用 由于缺乏合适的捐赠器官而严重受限安全 心脏和肺的保存时间仍限于4-6小时。 如此短时间的方法有三个主要缺点： (1)它限制了获得移植物的地理区域。(2)它 限制了组织相容性试验的驯服;（3）提高了 组织保护不充分的可能性。 的进步 心脏、肺等重要器官的保存技术， 肝脏是非常重要的，因为替代方法的长期 不存在人为的支持。 我们已经开发和研究了一种新的自灌注技术， 器官保存 动物被麻醉， 通气，心脏，肺，肝脏，胰腺，十二指肠和双肾 在被心脏灌注并被氧合的同时被整体移除， 肺 呼吸器用于通风。新鲜的血液， 电解质、抗生素和营养素通过静脉滴注注入。 不需要抗凝剂或正性肌力药物。这是一个自我- 它是一个封闭的、自我调节的系统，几乎不需要干预。 心脏把血液输送到各个器官。 肺吸收血液. 肝脏维持其生物功能。 电解质和水 维持平衡，代谢废物由肾脏排出。 这种制备保留了器官的自然解剖连接 没有外来物质的帮助，能量和基质 器官之间的交换得以保存。 在一项初步研究中， 驯服时间为41 ~ 60 h，血流动力学和器官功能稳定 功能 在这项建议中，我们打算研究以下两者之间的关系： 血小板聚集率与组织存活时间的关系 基质摄取和器官功能之间的关系;研究器官功能， 不同温度下的存活时间;移植心脏 在保存24小时后;并在12-24小时后移植心脏 4小时自体灌注保存加4-6小时低温 存储. 类似的研究以前没有做过。这些研究将 获得离体器官功能和存活的新知识， 长期自体灌注，并提供进一步评估可能的 这项技术的临床应用。

The objective of this study is to develop a safe and reliable technique for long-term organ preservation for transplantation. Organ transplantations have proved successful in the treatment of patients with end-stage organ failure. Application of these procedures is severely Limited by the lack of suitable donor organs. Safe preservation time for the heart and lungs Is still limited to 4-6 hours. Methods with such a short period of time have three main disadvantages: (1) It limits the geographic area from which to obtain grafts. (2) It limits the tame for histocompatibility tests and (3) It raises the possibility of inadequate tissue protection. Advancements in preservation techniques for vital organs such as the heart, lungs and liver are extremely important since alternative methods of long-term artificial support do not exist. We have developed and studied a new autoperfusion technique for long-term organ preservation. With the animals are anesthetized and artificially ventilated, the heart, lungs, liver, pancreas, duodenum and both kidneys are removed en bloc while being perfused by the heart and oxygenated by the lungs. A respirator is used for ventilation. Fresh blood, electrolytes, antibiotics and nutrients are infused by intravenous drip. No anticoagulants or inotropic drugs are necessary. This is a self- contained and self-adjusted system and requires very little intervention. The heart pumps blood to all the organs. The lungs oxygenate the blood. The liver maintains its biological functions. Electrolyte and water balances are maintained and metabolic wastes are removed by the kidneys. This preparation preserves the natural anatomic connections of the organs without assistance of foreign material, and the energy and substrate exchanges between organs are preserved. In a pilot study, the survival tame ranged from 41 to 60 hours with stable hemodynamics and organ function. In this proposal, we intend to study the relationship between platelet aggregation and tissue survival time; study the relationship between substrate uptake and organ function; study organ function and survival time under different temperature settings; transplant the heart after 24 hours of preservation; and transplant the heart after 12-24 hours of autoperfusion preservation plus 4-6 hours of hypothermic storage. Similar studies have not been done before. These studies will gain new knowledge of ex vivo organ function and survival during long-term autoperfusion and provide further evaluation for possible clinical application of this technique.