Courtwright Andrew, Cantu Edward
Division of Pulmonary and Critical Care Medicine, University of Pennsylvania School of Medicine, Gates 8, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Hospital of the University of Pennsylvania, 3400 Spruce Street, 6 Silverstein Pavilion, Philadelphia, PA 19104-4283, USA.
Clin Chest Med. 2017 Dec;38(4):751-759. doi: 10.1016/j.ccm.2017.07.007. Epub 2017 Aug 31.
The expansion of the donor lung pool has involved an evidence-driven redefinition of acceptable donors. Proceeding with transplantation with an acceptable rather than ideal donor depends on specific patient-related and organ-related risk factors as well as the severity of recipient illness. Although the physiologic optimization of brain-dead donors has not changed significantly in recent years, the use of donor management protocols has improved procurement rates. Ex vivo lung perfusion is an increasingly viable strategy to recondition lungs that would otherwise fall below the acceptable threshold for transplant. Ex vivo perfusion trials for preservation of standard donor lungs are ongoing.
供肺库的扩大涉及到基于证据对可接受供体的重新定义。使用可接受而非理想的供体进行移植取决于特定的患者相关和器官相关风险因素以及受体疾病的严重程度。尽管近年来脑死亡供体的生理优化没有显著变化，但供体管理方案的使用提高了获取率。体外肺灌注是一种越来越可行的策略，用于修复那些否则将低于移植可接受阈值的肺。用于保存标准供体肺的体外灌注试验正在进行中。
