D'Amico Davide Francesco, Vitale Alessandro, Cillo Umberto, Boccagni Patrizia, Brolese Alberto, Zanus Giacomo, Bassanello Marco, Montin Umberto, Gringeri Enrico, D'Amico Francesco, Ciarleglio Francesco, Cappuzzo Gianluca, Carraro Amedeo
Department of Surgical and Gastroenterological Sciences, University of Padua, School of Medicine, Padova, Italy.
Acta Biomed. 2003;74 Suppl 2:30-3.
Thermal homeostasis represents the major issue during liver transplantation (OLT) since severe hypothermia may have a deleterious effect on both liver recipient organism and postoperative graft functioning. Because of the known negative influence of hypothermia on intraoperative cardiovascular activity and coagulation system, numerous methods have been suggested to reduce intraoperative heat loss and promote active warming (continuous temperature monitoring, external heat sources, improvement in surgical technique and technologies). A good intraoperative OLT course has an obvious influence on post OLT graft function recovery, but thermal homeostasis has also an essential direct effect on the graft as a constitutive component of conventional cold preservation methods. Hypothermia, however, contributes directly to the graft ischemia-reperfusion injury particularly in marginal and partial organs by several angiogenic mechanisms. For these reasons, on the light of the development of new strategies to increase the donor pool, clinical research is focusing on new preservation methods such as extracorporeal circuits with normothermic oxygenated perfusion.
热稳态是肝移植（OLT）过程中的主要问题，因为严重低温可能对肝移植受体机体和术后移植物功能产生有害影响。鉴于低温对术中心血管活动和凝血系统的已知负面影响，人们提出了多种方法来减少术中热量损失并促进主动升温（连续温度监测、外部热源、手术技术和工艺的改进）。良好的术中OLT过程对OLT术后移植物功能恢复有明显影响，但热稳态作为传统冷保存方法的一个组成部分，对移植物也有至关重要的直接影响。然而，低温通过多种血管生成机制直接导致移植物缺血再灌注损伤，尤其是在边缘器官和部分器官中。由于这些原因，鉴于增加供体库新策略的发展，临床研究正聚焦于新的保存方法，如常温氧合灌注体外循环。
