a Inserm U1082 , Inserm, Poitiers , France.
b Fédération Hospitalo-Universitaire SUPORT , CHU Poitiers, Poitiers , France.
Expert Opin Investig Drugs. 2019 Jul;28(7):643-657. doi: 10.1080/13543784.2019.1628217. Epub 2019 Jun 11.
Delayed graft function (DGF) has a significant impact on kidney transplantation outcome. One of the underlying pivotal mechanisms is organ preservation and associated hypothermia and biochemical alteration.
This paper focuses on organ preservation and its clinical consequences and describes 1. A comprehensive presentation of the pathophysiological mechanism involved in delayed graft function development; 2. The impact on endothelial cells and microvasculature integrity and the consequences on transplanted organ outcome; 3. The reassessment of dynamic organ preservation motivated by the growing use of extended criteria donors and the interest in the potential of normothermia; 4. The role of oxygenation during dynamic preservation; and 5. Novel oxygen carriers and their proof of concept in transplantation, among which M101 (HEMOlife®) is currently the most extensively investigated.
Metabolic disturbances and imbalance of oxygen supply during preservation highlight the importance of providing oxygen. Normothermia, permitted by recent advances in machine perfusion technology, appears to be the leading edge of preservation technology. Several oxygen transporters are compatible with normothermia; however, only M101 also demonstrates compatibility with standard hypothermic preservation.
延迟移植物功能（DGF）对肾移植结果有重大影响。其潜在的关键机制之一是器官保存以及相关的低温和生化改变。
本文专注于器官保存及其临床后果，并描述了 1. 延迟移植物功能发展所涉及的病理生理机制的全面介绍；2. 对内皮细胞和微血管完整性的影响以及对移植器官结果的后果；3. 由扩展标准供体的日益使用和对正常温度潜力的兴趣重新评估动态器官保存；4. 氧合在动态保存中的作用；以及 5. 新型氧载体及其在移植中的概念验证，其中 M101（HEMOlife®）是目前研究最广泛的。
保存过程中的代谢紊乱和氧供应失衡强调了提供氧的重要性。允许在最近的机器灌注技术进步的条件下进行的常温似乎是保存技术的前沿。几种氧载体与常温兼容；然而，只有 M101 还显示与标准低温保存兼容。
