Cobo José Luis Escalante, Del Río Gallegos Francisco
Programa de Trasplantes, Hospital General Universitario Gregorio Marañón, Madrid, España.
Med Intensiva. 2009 Aug-Sep;33(6):282-92. doi: 10.1016/S0210-5691(09)72196-5.
Maintaining organ viability from extraction to transplantation is crucial to ensure the function and survival of the graft. In recent years, maintaining organ viability has become more challenging because the shortage of donors has led to broader criteria for donor acceptability and consequently to organs with greater compromise. Organ damage occurs primarily as a result of ischemia-reperfusion injury, which is associated to additional damage from the preservation process. To minimize this damage, different techniques of organ preservation are used with the aim of optimizing organ function once perfusion is restored. Static cold storage is the most commonly used method of preservation because it is extremely simple, nearly universally available, and easy to transport. However, static cold storage may be unable to prevent the deterioration of the quality of organs from donors included under the broader criteria. In this article, we describe current preservation techniques; we place special emphasis on continuous machine perfusion.
从摘取到移植过程中维持器官活力对于确保移植物的功能和存活至关重要。近年来,维持器官活力变得更具挑战性,因为供体短缺导致了更宽泛的供体可接受标准,从而导致器官受损更严重。器官损伤主要是由于缺血再灌注损伤所致,这与保存过程中的额外损伤相关。为了将这种损伤降至最低,人们采用了不同的器官保存技术,目的是在恢复灌注后优化器官功能。静态冷藏是最常用的保存方法,因为它极其简单,几乎随处可得且易于运输。然而,静态冷藏可能无法防止纳入更宽泛标准下的供体器官质量的恶化。在本文中,我们描述了当前的保存技术;我们特别强调持续机器灌注。