aDepartment of Renal Medicine & Transplantation, Barts Health NHS bQueen Mary University London, Charter House Square, London, UK.
Curr Opin Nephrol Hypertens. 2017 Nov;26(6):467-476. doi: 10.1097/MNH.0000000000000367.
Ischemia reperfusion injury (IRI) is an inevitable complication in solid organ transplantation. Limiting this injury can increase patient and graft survival and can decrease complications associated with transplantation. We provide an extensive literature review analyzing the available evidence for ischemic conditioning in solid organ transplantation, including kidney, liver, heart, and lung.
Ischemic conditioning strategies are a group of interventions, characterized by episodes of ischemia and reperfusion to an organ which confirm tissue protection. Arguably, transplantation is the ideal setting to use this novel strategy due to the predictable timing and duration of the ischemic insult. Liver transplantation has provided us with the most number of clinical trials, followed by kidney transplantation. Most of these trials have been negative but the methodology has been variable, making comparison difficult.
Despite the promising results seen in animal models, translating these results in clinical trials has proved to be difficult. The promising effects of ischemic conditioning are present in some trials with weaker positive signals existing in other trials. We believe that tailoring trials to allow better comparison will provide positive results in the future.
缺血再灌注损伤（IRI）是实体器官移植中不可避免的并发症。限制这种损伤可以提高患者和移植物的存活率，并降低与移植相关的并发症。我们提供了广泛的文献综述，分析了在实体器官移植中，包括肾脏、肝脏、心脏和肺，可用的缺血预处理的证据。
缺血预处理策略是一组干预措施，其特征是器官经历缺血和再灌注，以确认组织保护。可以说，由于缺血性损伤的可预测时间和持续时间，移植是使用这种新策略的理想环境。肝移植为我们提供了最多的临床试验，其次是肾移植。这些试验大多是阴性的，但方法学各不相同，使得比较困难。
尽管在动物模型中看到了有希望的结果，但将这些结果转化为临床试验证明是困难的。缺血预处理的有希望的效果在一些试验中存在，而在其他试验中存在较弱的阳性信号。我们相信，通过调整试验以允许更好的比较，将在未来提供积极的结果。
