Jochmans I, Akhtar M Z, Nasralla D, Kocabayoglu P, Boffa C, Kaisar M, Brat A, O'Callaghan J, Pengel L H M, Knight S, Ploeg R J
Abdominal Transplant Surgery, KU Leuven, University Hospitals Leuven, Leuven, Belgium.
Biomedical Research Centre and Oxford Transplant Centre, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Am J Transplant. 2016 Sep;16(9):2545-55. doi: 10.1111/ajt.13778. Epub 2016 Apr 1.
The increased demand for organs has led to the increased usage of "higher risk" kidney and liver grafts. These grafts from donation after circulatory death or expanded criteria donors are more susceptible to preservation injury and have a higher risk of unfavorable outcomes. Dynamic, instead of static, preservation could allow for organ optimization, offering a platform for viability assessment, active organ repair and resuscitation. Ex situ machine perfusion and in situ regional perfusion in the donor are emerging as potential tools to preserve and resuscitate vulnerable grafts. Preclinical findings have ignited clinical organ preservation research that investigates dynamic preservation, its various modes (continuous, preimplantation) and temperatures (hypo-, sub, or normothermic). This review outlines the current status of dynamic preservation of kidney and liver grafts and describes ongoing research and emerging clinical trials.
对器官需求的增加导致了“高风险”肾脏和肝脏移植物使用的增加。这些来自循环死亡后捐赠或扩大标准供体的移植物更容易受到保存损伤，且出现不良结果的风险更高。动态而非静态的保存方式可以实现器官优化，提供一个进行活力评估、主动器官修复和复苏的平台。供体的体外机器灌注和原位区域灌注正成为保存和复苏脆弱移植物的潜在工具。临床前研究结果引发了临床器官保存研究，该研究调查动态保存、其各种模式（持续、植入前）和温度（低温、亚低温或常温）。本综述概述了肾脏和肝脏移植物动态保存的现状，并描述了正在进行的研究和新出现的临床试验。
