Department of Mechanical Engineering and Engineering Science; University of North Carolina; Charlotte, NC USA.
Organogenesis. 2009 Jul;5(3):105-12. doi: 10.4161/org.5.3.9582.
With the successful testing of the immunosuppressive effects of cyclosporine in transplant patients in 1978, the field of organ transplants began an exponential growth. With that, the field of organ preservation became increasingly important as the need to increase preservation time and improve graft function became paramount. However, for every patient that receives a transplanted organ, there are four more on the waiting list. In addition, a patient dies from the lack of a transplant almost every 1(1/2) hour. To alleviate this donor crisis, there is a need to expand the donor pool to marginal donor organs. The main reason these organs are underutilized is because the current method of static preservation, simple cold storage, is ineffective. This article will provide a general review of the methods of preservation including simple cold storage, hypothermic machine perfusion, normothermic machine perfusion, and oxygen persufflation. In addition, the article will provide a review of how these dynamic preservation methods have improved the recovery and preservation of marginal donor organs including Donation after Cardiac Death and Fatty livers.
1978 年,环孢素在移植患者中的免疫抑制作用成功测试后,器官移植领域开始呈指数级增长。随着保存时间的延长和移植物功能的改善变得至关重要,器官保存领域变得越来越重要。然而,每有一位患者接受移植器官,就有四位患者在等待名单上。此外,几乎每 1(1/2)小时就有一名患者因缺乏移植而死亡。为了缓解这种供体危机,需要扩大供体库以利用边缘供体器官。这些器官未得到充分利用的主要原因是当前的静态保存方法,即单纯低温保存,效果不佳。本文将对保存方法进行综述,包括简单低温保存、低温机器灌注、常温机器灌注和氧灌输。此外,本文还将综述这些动态保存方法如何改善边缘供体器官的恢复和保存,包括心脏死亡后捐献和脂肪肝。