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肝脏常温机器保存:现状

Normothermic Machine Preservation of the Liver: State of the Art.

作者信息

Ceresa Carlo D L, Nasralla David, Jassem Wayel

机构信息

1Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.

2Institute of Liver Studies, King's College Hospital, London, UK.

出版信息

Curr Transplant Rep. 2018;5(1):104-110. doi: 10.1007/s40472-018-0186-9. Epub 2018 Feb 27.

Abstract

PURPOSE OF REVIEW

This review aims to introduce the concept of normothermic machine perfusion (NMP) and its role in liver transplantation. By discussing results from recent clinical studies and highlighting the potential opportunities provided by this technology, we aim to provide a greater insight into NMP and the role it can play to enhance liver transplantation.

RECENT FINDINGS

NMP has recently been shown to be both safe and feasible in liver transplantation and has also demonstrated its superiority to traditional cold storage in terms of early biochemical liver function. Through the ability to perform a viability assessment during preservation and extend preservation times, it is likely that an increase in organ utilisation will follow. NMP may facilitate the enhanced preservation with improved outcomes from donors after cardiac death and steatotic livers. Furthermore, it provides the exciting potential for liver-directed therapeutic interventions.

SUMMARY

Evidence to date suggests that NMP facilitates the enhanced preservation of liver grafts with improved early post-transplant outcomes. The key role for this technology is to increase the number and quality of liver grafts available for transplantation and to reduce waiting list deaths.

摘要

综述目的

本综述旨在介绍常温机器灌注(NMP)的概念及其在肝移植中的作用。通过讨论近期临床研究结果并强调该技术提供的潜在机会,我们旨在更深入地了解NMP及其在增强肝移植方面所能发挥的作用。

最新发现

最近的研究表明,NMP在肝移植中既安全又可行,并且在早期生化肝功能方面也已证明其优于传统冷保存。通过在保存期间进行活力评估以及延长保存时间的能力,器官利用率可能会随之提高。NMP可能有助于增强对心脏死亡后供体肝脏和脂肪变性肝脏的保存,从而改善其预后。此外,它为肝脏定向治疗干预提供了令人兴奋的潜力。

总结

迄今为止的证据表明,NMP有助于增强肝移植供肝的保存,改善移植后的早期预后。这项技术的关键作用是增加可用于移植的肝移植数量和质量,并减少等待名单上的死亡人数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cceb/5843699/e33dbd97ffba/40472_2018_186_Fig1_HTML.jpg

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