Szust J, Olson L, Cravero L
University of Miami Organ Procurement Organization, USA.
J Transpl Coord. 1999 Jun;9(2):97-100. doi: 10.7182/prtr.1.9.2.150x67kn7750w444.
Kidney preservation has been performed by either ice (static) or machine pulsatile perfusion. Ice storage is simple, with only 1 methodology. Machine perfusion, on the other hand, is accomplished using multiple methodologies. This article delineates the different methodologies of pumping centers throughout the country.
Pulsatile machine perfusion is again being viewed as the preservation method of choice for kidneys from non-heart-beating cadaver donors and cadaver kidneys from marginal donors. To develop indices to predict the viability of cadaver kidneys for transplant, a review of the organ procurement organizations, specific perfusion techniques, and a comparison of the delayed graft function and graft survival rates were considered.
A survey, asking for specifics on perfusion parameters, pulsatile machine perfusion experience, and criteria for perfusion implementation and graft survival results, was mailed to all organ procurement organizations in the United States.
Of the 44 centers that responded to the survey, 12 used pulsatile machine perfusion (11 used the Waters perfusion machine), 6 pumped marginal cadaver kidneys, and the remaining 6 pumped all cadaver kidneys. Minimum perfusion criteria, pulse rates, perfusate composition, pressures, renal resistance, and renal pressure and flow were considered. Vasodilators and other machine additives were used to improve flow. The variance in each center's number of cadaver kidneys pumped each year, as well as the differences in pump times, was noted.
Twelve centers use pulsatile machine perfusion. A variety of techniques are used to perform pulsatile machine perfusion, but 11 of 12 have less delayed graft function than those programs employing ice storage preservation.
肾脏保存可通过冰（静态）保存或机器搏动灌注来进行。冰储存很简单，只有一种方法。另一方面，机器灌注则使用多种方法来完成。本文阐述了全国各灌注中心的不同方法。
搏动性机器灌注再次被视为非心脏跳动尸体供者肾脏以及边缘供者尸体肾脏的首选保存方法。为了制定预测尸体肾脏移植存活率的指标，对器官获取组织、具体灌注技术进行了综述，并比较了延迟移植肾功能和移植存活率。
向美国所有器官获取组织邮寄了一份调查问卷，询问灌注参数、搏动性机器灌注经验、灌注实施标准和移植存活结果等具体信息。
在回复调查的44个中心中，12个使用搏动性机器灌注（11个使用沃特斯灌注机），6个灌注边缘尸体肾脏，其余6个灌注所有尸体肾脏。考虑了最低灌注标准、脉搏率、灌注液成分、压力、肾阻力以及肾压力和血流量。使用血管扩张剂和其他机器添加剂来改善血流量。记录了每个中心每年灌注的尸体肾脏数量差异以及灌注时间差异。
12个中心使用搏动性机器灌注。多种技术用于进行搏动性机器灌注，但12个中心中有11个的延迟移植肾功能比采用冰储存保存的项目少。
