Department of Urology and Transplantation Surgery, Nantes, France; Nuffield Department of Surgical Science, Oxford, United Kingdom; Centre de Recherche en Transplantation et Immunologie (ou CRTI), Inserm, Nantes University, Nantes, France.
Nuffield Department of Surgical Science, Oxford, United Kingdom.
Transplant Proc. 2022 Jan-Feb;54(1):77-79. doi: 10.1016/j.transproceed.2021.09.059. Epub 2021 Dec 5.
Kidney and pancreatic transplants from controlled donation after circulatory death donors are vulnerable to ischemia-reperfusion injuries. In this context of transplant shortage, there is a need to optimize the function of these transplants and to develop novel perfusion and preservation strategies in controlled donation after circulatory death in kidney and pancreatic transplants.
In situ regional normothermic perfusion improves the outcome of kidney transplants from controlled donation after circulatory death and provides equivalent results for the kidney from brain-dead donors. In situ regional normothermic perfusion is under investigation for pancreatic transplants.
Perfusion on hypothermic machine perfusion is highly recommended for the kidney from controlled donation after cardiac death. Hypothermic oxygenated perfusion machine decreases the rate of graft rejection and graft failure in kidney transplantation. Ex situ normothermic perfusion is an easy way to assess renal function. In the future, kidney transplants could benefit from drug therapy during ex situ normothermic perfusion. In pancreas transplantation, hypothermic machine perfusion and ex situ normothermic perfusion present encouraging results in preclinical studies.
来自控制性心脏死亡后捐献者的肾脏和胰腺移植容易受到缺血再灌注损伤。在这种移植短缺的情况下，有必要优化这些移植的功能，并为肾脏和胰腺移植的控制性心脏死亡后开发新的灌注和保存策略。
原位区域性常温灌注可改善控制性心脏死亡后捐献者的肾脏移植效果，并为脑死亡供体的肾脏提供等效结果。原位区域性常温灌注正在研究用于胰腺移植。
低温机器灌注对心脏死亡后控制性捐献的肾脏高度推荐。低温充氧机器灌注可降低肾移植中移植物排斥和移植物衰竭的发生率。体外常温灌注是评估肾功能的一种简单方法。将来，肾脏移植可能受益于体外常温灌注期间的药物治疗。在胰腺移植中，低温机器灌注和体外常温灌注在临床前研究中呈现出令人鼓舞的结果。
