Casanova Daniel, Gutierrez Gonzalo, Gonzalez Noriega Monica, Castillo Federico
Department of Surgery, University Hospital Marques de Valdecilla, University Cantabria, Santander 39008, Cantabria, Spain.
Department of Surgery, University Hospital Marques de Valdecilla, Santander 39008, Cantabria, Spain.
World J Transplant. 2020 Dec 28;10(12):381-391. doi: 10.5500/wjt.v10.i12.381.
In pancreas transplantation, complications can arise at each step of the process, from the initial selection of donors and recipients through the surgical technique itself and the post-operative period, when lifelong immunosuppression is required. In the early steps, careful retrieval and preservation of the pancreas are crucial for the viability of the organ and ultimate success of the transplant. The pancreas is a low-flow gland, making it highly sensitive to transplantation conditions and presenting risk of pancreatitis due to periods of ischemia. The two groups of donors - after brain death (DBD) or after cardiac arrest (DCD) - require different strategies of retrieval and preservation to avoid or reduce the risk of complications developing during and after the transplantation. For DBD donor transplantation, multiorgan retrieval and cold preservation is the conventional technique. Asystole donor (DCD) transplantation, in contrast, can benefit from the newest technologies, such as hypothermic and especially normothermic preservation machines (referred to as NECMO), to optimize organ preservation. The latter has led to an increase in the pool of donors by facilitating recuperation of organs for transplantation that would have been discarded otherwise.
在胰腺移植过程中，从供体和受体的最初选择，到手术技术本身以及术后需要终身免疫抑制的阶段，该过程的每一步都可能出现并发症。在早期阶段，胰腺的仔细获取和保存对于器官的存活以及移植的最终成功至关重要。胰腺是低血流腺体，这使其对移植条件高度敏感，并且由于缺血期存在胰腺炎风险。两组供体——脑死亡后供体（DBD）或心脏骤停后供体（DCD）——需要不同的获取和保存策略，以避免或降低移植期间及术后出现并发症的风险。对于DBD供体移植，多器官获取和冷保存是传统技术。相比之下，心脏停搏供体（DCD）移植可受益于最新技术，如低温尤其是常温保存机器（称为NECMO），以优化器官保存。后者通过促进原本会被丢弃的用于移植的器官的恢复，增加了供体库。
