Department of Surgery, Nordsjællands Hospital, Dyrehavevej 29, 3400 Hillerød, Denmark.
Department of Surgical Gastroenterology and Transplantation, Abdominal Centre, Rigshospitalet, Blegdamsvej 9, 2100 Købehnavn Ø, Denmark.
Transplant Rev (Orlando). 2018 Jan;32(1):10-15. doi: 10.1016/j.trre.2017.06.001. Epub 2017 Jun 15.
Solid organ transplantation is an accepted treatment for end-stage solid organ diseases. During the procedure, ischemia and reperfusion injury may affect graft and patient outcomes. Remote ischemic preconditioning (rIC) has been shown to reduce ischemia and reperfusion injury and can be performed safely. Thus, rIC may potentially improve outcomes after solid organ transplantation. Traditionally, the focus of rIC has been on the donor. However, preconditioning the recipient may be a more suitable approach in transplant settings. The current review analyzed previously published studies where rIC was performed on transplant recipients.
PubMed and EMBASE databases were searched for eligible clinical and animal studies evaluating rIC of recipients. Articles were analyzed and compared qualitatively. Risk of bias was assessed using the Cochrane Collaboration's tool for interventional clinical studies and SYRCLEs risk of bias tool for animal studies.
A total of 12 studies were included. Overall, these studies were heterogeneous due to differences in populations and intervention set-up. Some of the studies suggested improvement of graft function, while other studies did not show any effect. The quality of the 12 included studies was predominantly low.
Due to the heterogeneity and quality of the included studies the result, that rIC may be beneficial in transplantation of some organs, should be interpreted with caution. The result must be confirmed by further clinical studies.
实体器官移植是治疗终末期实体器官疾病的一种公认的治疗方法。在手术过程中，缺血再灌注损伤可能会影响移植物和患者的预后。远程缺血预处理 (rIC) 已被证明可减轻缺血再灌注损伤，且安全可行。因此，rIC 可能会改善实体器官移植后的结果。传统上，rIC 的焦点是供体。然而，在移植环境中，对受者进行预处理可能是一种更合适的方法。本综述分析了先前发表的对移植受者进行 rIC 的研究。
在 PubMed 和 EMBASE 数据库中搜索评估 rIC 的受者的合格临床和动物研究。对文章进行分析和定性比较。使用 Cochrane 协作组的干预性临床研究工具和 SYRCLEs 动物研究偏倚工具评估偏倚风险。
共纳入 12 项研究。总体而言，由于人群和干预方案的差异，这些研究存在异质性。一些研究表明移植物功能得到改善，而其他研究则没有显示出任何效果。12 项纳入研究的质量主要较低。
由于纳入研究的异质性和质量，rIC 可能对某些器官的移植有益的结果应谨慎解释。该结果必须通过进一步的临床研究来证实。
