Michel S G, LaMuraglia Ii G M, Madariaga M L L, Anderson Lisa M
Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA ; Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany.
Transplantation Biology Research Center, Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Heart Lung Vessel. 2015;7(3):246-55.
Currently, the gold standard for donor organ preservation in clinical organ transplantation consists of 3 plastic bags and an ice box. The first plastic bag includes the organ itself immersed in preservation solution (e.g. Celsior). This bag is put in a second bag filled with saline, and then these two are put in a third bag filled with saline which is then put in the ice box. The disadvantage of this method is that the organ usually gets too cold. It has been shown that the theoretical perfect temperature for organ preservation is 4°C - 8°C. While higher temperatures lead to hypoxic injury of the organ because the metabolism is not decreased efficiently, lower temperatures than 4°C increase the risk of cold injury with protein denaturation. In the current study, we investigated a device that keeps the organ temperature consistently in the desired range of 4°C - 8°C and can potentially decrease cold injury to donor organs.
Three different ex vivo studies were performed with the Paragonix Sherpa Pak™ devices: 1) the temperature of the fluid-filled device was measured for up to 30 hours at an outside temperature set at 22°C, 2) the temperature of the fluid-filled device was measured for up to 30 hours at extreme outside temperatures set at -8°C and 31°C, 3) the temperature of a pig heart attached to the device was measured up to 12 hours.
All studies showed that the Paragonix Sherpa Pak™ can keep the temperature of the heart consistently between 4° and 8°C.
The Paragonix Sherpa Pak™ device may decrease cold injury of donor organs by maintaining the temperature consistently between 4°C and 8°C and therefore may decrease primary graft failure after organ transplantation.
目前,临床器官移植中供体器官保存的金标准是使用3个塑料袋和1个冰盒。第一个塑料袋装有浸泡在保存液(如Celsior)中的器官本身。这个袋子被放入第二个装满盐水的袋子中,然后这两个袋子再被放入第三个装满盐水的袋子中,最后将第三个袋子放入冰盒。这种方法的缺点是器官通常会变得太冷。研究表明,器官保存的理论理想温度是4°C - 8°C。虽然较高的温度会导致器官缺氧损伤,因为代谢没有有效降低,但低于4°C的温度会增加蛋白质变性导致冷损伤的风险。在本研究中,我们研究了一种能将器官温度持续保持在4°C - 8°C所需范围内,并有可能减少对供体器官冷损伤的装置。
使用Paragonix Sherpa Pak™装置进行了三项不同的体外研究:1)在设定为22°C的外部温度下,对充满液体的装置温度进行长达30小时的测量;2)在设定为 - 8°C和31°C的极端外部温度下,对充满液体的装置温度进行长达30小时的测量;3)对连接到该装置的猪心脏温度进行长达12小时的测量。
所有研究均表明,Paragonix Sherpa Pak™能将心脏温度持续保持在4°至8°C之间。
Paragonix Sherpa Pak™装置通过将温度持续保持在4°C至8°C之间,可能减少供体器官的冷损伤,因此可能降低器官移植后的原发性移植物功能衰竭。