Centre for Evidence in Transplantation, Clinical Effectiveness Unit, Royal College of Surgeons of England and the London School of Hygiene and Tropical Medicine, University of London, London, UK; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Centre for Evidence in Transplantation, Clinical Effectiveness Unit, Royal College of Surgeons of England and the London School of Hygiene and Tropical Medicine, University of London, London, UK.
Transplant Rev (Orlando). 2017 Jul;31(3):172-179. doi: 10.1016/j.trre.2017.02.001. Epub 2017 Feb 17.
We reviewed the evidence for ex-vivo Supplemental Oxygen during Hypothermic preservation (SOH) for deceased donor kidneys. Bibliographic databases were searched for human and animal studies of SOH in kidney transplantation reporting on patient or animal survival rate, discard rate, technical complications or renal function outcomes. We make special reference to a specific subgroup: supplemental oxygen applied during cold perfusion, referred to as Hypothermic Oxygenated Perfusion (HOP). Four human and 25 animal studies were identified. The data present conflicting results but suggest that the effects of oxygen on restoring kidney function during preservation may be of value for DCD kidneys and/or kidneys that have undergone a period of hypotension, warm ischemia or poor perfusion in the donor. There is very little information available from human or animal studies. This work highlights to the transplant community that far more high quality clinical studies are required to understand this technology and its role before widespread clinical introduction.
我们回顾了在低温保存期间（SOH）对已故供体肾脏进行体外补充氧气的证据。检索了人类和动物的 SOH 在肾脏移植中报告患者或动物存活率、废弃率、技术并发症或肾功能结果的研究。我们特别提到了一个特定的亚组：在冷灌注期间应用的补充氧气，称为低温氧合灌注（HOP）。确定了 4 项人类研究和 25 项动物研究。数据显示结果相互矛盾，但表明在保存过程中氧气对恢复肾功能的作用可能对 DCD 肾脏和/或经历低血压、热缺血或供体灌注不良的肾脏有价值。从人类或动物研究中获得的信息非常有限。这项工作向移植界强调，需要开展更多高质量的临床研究，才能在广泛的临床应用之前了解这项技术及其作用。
