De Deken Julie, Kocabayoglu Peri, Moers Cyril
aDepartment of General, Visceral, Thoracic and Pediatric Surgery, Klinikum Saarbrücken, Saarbrücken, Germany bDepartment of Microbiology and Immunology, Laboratory of Abdominal Transplantation, Katholieke Universiteit Leuven, Leuven, Belgium cDepartment of General, Visceral and Transplant Surgery, Faculty of Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany dDepartment of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
Curr Opin Organ Transplant. 2016 Jun;21(3):294-300. doi: 10.1097/MOT.0000000000000306.
This article summarizes novel developments in hypothermic machine perfusion (HMP) as an organ preservation modality for kidneys recovered from deceased donors.
HMP has undergone a renaissance in recent years. This renewed interest has arisen parallel to a shift in paradigms; not only optimal preservation of an often marginal quality graft is required, but also improved graft function and tools to predict the latter are expected from HMP. The focus of attention in this field is currently drawn to the protection of endothelial integrity by means of additives to the perfusion solution, improvement of the HMP solution, choice of temperature, duration of perfusion, and machine settings. HMP may offer the opportunity to assess aspects of graft viability before transplantation, which can potentially aid preselection of grafts based on characteristics such as perfusate biomarkers, as well as measurement of machine perfusion dynamics parameters.
HMP has proven to be beneficial as a kidney preservation method for all types of renal grafts, most notably those retrieved from extended criteria donors. Large numbers of variables during HMP, such as duration, machine settings and additives to the perfusion solution are currently being investigated to improve renal function and graft survival. In addition, the search for biomarkers has become a focus of attention to predict graft function posttransplant.
本文总结了低温机器灌注（HMP）作为从已故供体获取的肾脏的一种器官保存方式的新进展。
近年来，HMP经历了复兴。这种重新燃起的兴趣与范式转变同时出现；不仅需要对通常质量欠佳的移植物进行最佳保存，还期望HMP能改善移植物功能并提供预测功能的工具。目前该领域的关注焦点在于通过向灌注液中添加添加剂来保护内皮完整性、改进HMP溶液、选择温度、灌注持续时间和机器设置。HMP可能提供在移植前评估移植物存活情况的机会，这有可能有助于根据诸如灌注液生物标志物等特征以及机器灌注动力学参数的测量对移植物进行预选。
HMP已被证明作为所有类型肾移植物的肾脏保存方法是有益的，对于那些从扩大标准供体获取的移植物尤其如此。目前正在研究HMP过程中的大量变量，如持续时间、机器设置和灌注液添加剂，以改善肾功能和移植物存活。此外，寻找生物标志物已成为预测移植后移植物功能的关注焦点。
