Center for Liver Disease and Transplantation, Department of Surgery, Columbia University Medical Center, New York, NY, USA.
Am J Transplant. 2010 Feb;10(2):372-81. doi: 10.1111/j.1600-6143.2009.02932.x. Epub 2009 Dec 2.
Hypothermic machine perfusion (HMP) is widely used to preserve kidneys for transplantation with improved results over cold storage (CS). To date, successful transplantation of livers preserved with HMP has been reported only in animal models. In this, the first prospective liver HMP study, 20 adults received HMP-preserved livers and were compared to a matched group transplanted with CS livers. HMP was performed for 3-7 h using centrifugal perfusion with Vasosol solution at 4-6 degrees C. There were no cases of primary nonfunction in either group. Early allograft dysfunction rates were 5% in the HMP group versus 25% in controls (p = 0.08). At 12 months, there were two deaths in each group, all unrelated to preservation or graft function. There were no vascular complications in HMP livers. Two biliary complications were observed in HMP livers compared with four in the CS group. Serum injury markers were significantly lower in the HMP group. Mean hospital stay was shorter in the HMP group (10.9 +/- 4.7 days vs. 15.3 +/- 4.9 days in the CS group, p = 0.006). HMP of donor livers provided safe and reliable preservation in this pilot case-controlled series. Further multicenter HMP trials are now warranted.
低温机器灌注（HMP）被广泛用于保存供移植的肾脏，与冷藏（CS）相比，效果有所改善。迄今为止，仅在动物模型中报道了使用 HMP 保存的肝脏成功移植。在这项前瞻性肝 HMP 研究中，20 名成年人接受了 HMP 保存的肝脏，并与接受 CS 肝脏移植的匹配组进行了比较。HMP 使用 Vasosol 溶液在 4-6 摄氏度下进行离心灌注，持续 3-7 小时。两组均无原发性无功能病例。HMP 组的早期移植物功能障碍发生率为 5%，对照组为 25%（p=0.08）。在 12 个月时，每组均有 2 例死亡，均与保存或移植物功能无关。HMP 肝脏无血管并发症。与 CS 组的 4 例相比，HMP 肝脏观察到 2 例胆漏并发症。HMP 组的血清损伤标志物显著降低。HMP 组的平均住院时间较短（10.9+/-4.7 天 vs. CS 组的 15.3+/-4.9 天，p=0.006）。在这项初步病例对照系列研究中，供体肝脏的 HMP 提供了安全可靠的保存。现在需要进行更多的多中心 HMP 试验。
