Hosgood Sarah A, van Heurn Ernest, Nicholson Michael L
Department of Infection Immunity and Inflammation, Transplant Group, University of Leicester, Leicester General Hospital, Leicester, UK.
Department of General Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
Transpl Int. 2015 Jun;28(6):657-64. doi: 10.1111/tri.12319. Epub 2014 May 8.
Kidney transplantation is limited by hypothermic preservation techniques. Prolonged periods of cold ischaemia increase the risk of early graft dysfunction and reduce long-term survival. To extend the boundaries of transplantation and utilize kidneys from more marginal donors, improved methods of preservation are required. Normothermic perfusion restores energy levels in the kidney allowing renal function to be restored ex vivo. This has several advantages: cold ischaemic injury can be avoided or minimized, the kidney can be maintained in a stable state allowing close observation and assessment of viability and lastly, it provides the ideal opportunity to add therapies to directly manipulate and improve the condition of the kidney. This review explores the experimental and clinical evidence for ex vivo normothermic perfusion in kidney transplantation and its role in conditioning and repair.
肾脏移植受低温保存技术的限制。长时间的冷缺血会增加早期移植肾功能障碍的风险并降低长期存活率。为了扩大移植的范围并利用更多边缘供体的肾脏，需要改进保存方法。常温灌注可恢复肾脏中的能量水平，使肾功能在体外得以恢复。这具有几个优点：可以避免或最小化冷缺血损伤，肾脏可以维持在稳定状态，便于密切观察和评估其活力，最后，它提供了添加疗法以直接操控和改善肾脏状况的理想机会。本综述探讨了肾脏移植中体外常温灌注的实验和临床证据及其在预处理和修复中的作用。
