Salehi Sara, Tran Kenny, Grayson Warren L
Translational Tissue Engineering Center, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD.
Yale J Biol Med. 2018 Sep 21;91(3):301-312. eCollection 2018 Sep.
In the past, a diagnosis of organ failure would essentially be a death sentence for patients. With improved techniques for organ procurement and surgical procedures, transplantations to treat organ failure have become standard medical practice. However, while the demand for organs has skyrocketed, the donor pool has not kept pace leading to long recipient waiting lists. Organ preservation provides a means to increase the number of available transplantable organs. However, there are significant drawbacks associated with cold storage, the current gold standard. To address the short-comings due to diffusional limitations, engineers have developed cold perfusion systems. More recently, there has been a significant trend towards the development of near-normothermic systems to enhance the functional preservation of solid organs including livers, lungs, hearts, kidneys, and vascularized composite allotransplants. Here we review recent advances in the development of perfusion systems for the preservation of solid organs. We provide a brief history of organ transplantation, the limitations of existing systems, and describe research being done to develop commercially available perfusion systems to enhance organ preservation.
过去,器官衰竭的诊断对患者来说基本上等同于死刑判决。随着器官获取技术和外科手术的改进,用于治疗器官衰竭的移植手术已成为标准医疗实践。然而,尽管对器官的需求急剧飙升,但供体库却未能跟上步伐,导致受体等待名单很长。器官保存提供了一种增加可用于移植器官数量的方法。然而,作为当前金标准的冷藏存在显著缺点。为了解决因扩散限制导致的不足,工程师们开发了冷灌注系统。最近,出现了一种向近常温系统发展的显著趋势,以增强包括肝脏、肺、心脏、肾脏和血管化复合异体移植在内的实体器官的功能保存。在此,我们综述了用于实体器官保存的灌注系统开发的最新进展。我们提供了器官移植的简要历史、现有系统的局限性,并描述了为开发可商购的灌注系统以增强器官保存而正在进行的研究。