Zhao Qiang, Huang Shanzhou, Wang Dongping, Zhang Zhiheng, Wu Linwei, Yang Lu, Ma Yi, Ji Fei, Tang Yunhua, Wang Linhe, Zhu Zebin, Zhu Yanling, Xiong Wei, Chen Maogen, Han Ming, Zhou Jian, Hu Anbin, Wang Guodong, Jiao Xingyuan, Zhu Xiaofeng, Ju Weiqiang, Guo Zhiyong, He Xiaoshun
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China (mainland).
Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, Guangdong, China (mainland).
Ann Transplant. 2018 Apr 20;23:258-267. doi: 10.12659/AOT.909645.
BACKGROUND In contrast to conventional static cold preservation, normothermic machine perfusion (NMP) provides a beneficial alternative preservation of donor livers. However, the liver still suffered cold ischemic injury before attaching to the perfusion device. MATERIAL AND METHODS To prevent cold ischemic injury during procurement, we describe a novel procedure called ischemia-free liver procurement (IFLP) under NMP. Two liver grafts were procured from brain death donor under NMP and underwent 2-hour ex vivo NMP followed by 3 and 6 hours of static cold preservation. From procurement to post-transplantation course, evidence was collected to prove that IFLP is safe and benefits recipients. RESULTS The post-transplantation course was uneventful, and the liver function tests and histological study revealed minimal hepatocyte and biliary epithelium injury during the preservation. CONCLUSIONS This preliminary experience demonstrates the clinical feasibility and safety of IFLP under NMP which offering opportunities to increase the number of donor livers and to improve the organ function.
与传统的静态冷保存不同，常温机器灌注（NMP）为供肝提供了一种有益的替代性保存方法。然而，肝脏在连接到灌注装置之前仍会遭受冷缺血损伤。材料与方法：为了在获取过程中预防冷缺血损伤，我们描述了一种在NMP下进行的名为无缺血肝脏获取（IFLP）的新方法。从脑死亡供体在NMP下获取了两个肝移植物，进行了2小时的体外NMP，随后进行了3小时和6小时的静态冷保存。从获取到移植后过程，收集证据以证明IFLP是安全的且对受者有益。结果：移植后过程顺利，肝功能测试和组织学研究显示在保存期间肝细胞和胆管上皮损伤最小。结论：这一初步经验证明了在NMP下IFLP的临床可行性和安全性，这为增加供肝数量和改善器官功能提供了机会。
