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肾脏的常温机器灌注

Normothermic machine perfusion of the kidney.

作者信息

Weissenbacher Annemarie, Hunter James

机构信息

aOxford Transplant Centre, Nuffield Department of Surgical Sciences, Churchill Hospital, Oxford, United Kingdom bDepartment for Visceral, Thoracic and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria.

出版信息

Curr Opin Organ Transplant. 2017 Dec;22(6):571-576. doi: 10.1097/MOT.0000000000000470.

Abstract

PURPOSE OF REVIEW

Normothermic machine perfusion (NMP) is a preservation method that is generating increasing interest. The aim of this review is to summarise the current status of NMP in regards of kidney viability assessment, reducing organ damage and improving transplant logistics.

RECENT FINDINGS

The results of recent large animal experiments and clinical trials show that continuous prolonged normothermic ex-vivo kidney perfusion appears better than a brief period of NMP after static cold storage in terms of renal injury and function. A recently developed clinical scoring system appears to correlate with renal and tubular function. A prospective clinical phase II trial to investigate the initial graft function after 1 h of NMP or static cold storage in kidneys from donors after circulatory death has been initiated in the United Kingdom.

SUMMARY

Progress has been made in normothermic kidney perfusion, mainly in experimental settings. These results need to be translated into clinical trials to evaluate long-term NMP and its impact in human organs. Future investigations of optimal perfusion parameters are needed.

摘要

综述目的

常温机器灌注(NMP)是一种正引发越来越多关注的保存方法。本综述旨在总结NMP在肾脏活力评估、减少器官损伤及改善移植物流方面的现状。

最新发现

近期大型动物实验和临床试验结果表明,就肾损伤和功能而言,持续长时间的常温体外肾脏灌注似乎优于静态冷藏后的短时间NMP。最近开发的一种临床评分系统似乎与肾脏和肾小管功能相关。英国已启动一项前瞻性临床II期试验,以研究循环死亡后供体肾脏经1小时NMP或静态冷藏后的初始移植肾功能。

总结

常温肾脏灌注已取得进展,主要是在实验环境中。这些结果需要转化为临床试验,以评估长期NMP及其对人体器官的影响。未来需要对最佳灌注参数进行研究。

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