Kumar Rohan, Chung Wen Yuan, Dennison Ashley Robert, Garcea Giuseppe
Department of Hepato-Pancreato-Biliary Surgery, University Hospitals of Leicester, Leicester, UK.
Artif Organs. 2017 Sep;41(9):E69-E79. doi: 10.1111/aor.12865. Epub 2017 Mar 6.
In transplantation surgery, extending the criteria for organ donation to include organs that may have otherwise been previously discarded has provided the impetus to improve organ preservation. The traditional method of cold static storage (CS) has been tried and tested and is suitable for organs meeting standard criteria donation. Ex vivo machine perfusion is, however, associated with evidence suggesting that it may be better than CS alone and may allow for organ donation criteria to be extended. Much of our knowledge of organ preservation is derived from animal studies. We review ex vivo porcine organ perfusion models and discuss the relevance to the field of transplantation surgery. Following a systematic literature search, only articles that reported on experimental studies with focus on any aspect(s) of ex vivo and porcine perfusion of organs yet limited to the context of organ transplantation surgery were included. The database search and inclusion/exclusion criteria identified 22 journal articles. All 22 articles discussed ex vivo porcine organ perfusion within the context of transplant preservation surgery: 8 liver, 3 kidney, 3 lung, 2 pancreas/islet, 4 discussed a combined liver-kidney multiorgan model, 1 small bowel, and 1 cardiac perfusion model systems. The ex vivo porcine perfusion model is a suitable, reliable, and safe translational research model. It has advantages to investigate organ preservation techniques in a reproducible fashion in order to improve our understanding and has implications to extend the criteria for organ donation.
在移植手术中,扩大器官捐赠标准以纳入那些原本可能被弃用的器官,为改进器官保存提供了动力。传统的冷静态保存(CS)方法已经经过试验和检验,适用于符合标准捐赠标准的器官。然而,有证据表明,体外机器灌注可能比单独的冷静态保存更好,并且可能允许扩大器官捐赠标准。我们对器官保存的许多了解都来自动物研究。我们回顾了体外猪器官灌注模型,并讨论了其与移植手术领域的相关性。经过系统的文献检索,仅纳入了那些报道了聚焦于器官体外和猪灌注的任何方面、但限于器官移植手术背景的实验研究的文章。数据库搜索和纳入/排除标准确定了22篇期刊文章。所有22篇文章都在移植保存手术的背景下讨论了体外猪器官灌注:8篇关于肝脏,3篇关于肾脏,3篇关于肺,2篇关于胰腺/胰岛,4篇讨论了肝肾联合多器官模型,1篇关于小肠,1篇关于心脏灌注模型系统。体外猪灌注模型是一种合适、可靠且安全的转化研究模型。它具有以可重复的方式研究器官保存技术的优势,以便增进我们的理解,并对扩大器官捐赠标准具有启示意义。