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在进行3天的体外常温保存后进行人体肝脏移植。

Transplantation of a human liver following 3 days of ex situ normothermic preservation.

作者信息

Clavien Pierre-Alain, Dutkowski Philipp, Mueller Matteo, Eshmuminov Dilmurodjon, Bautista Borrego Lucia, Weber Achim, Muellhaupt Beat, Sousa Da Silva Richard X, Burg Brian R, Rudolf von Rohr Philipp, Schuler Martin J, Becker Dustin, Hefti Max, Tibbitt Mark W

机构信息

Department of Surgery and Transplantation, Swiss Hepato-Pancreato-Biliary (HPB) and Transplant Center, University Hospital Zurich, Zurich, Switzerland.

Wyss Zurich Translational Center, ETH Zurich and University of Zurich, Zurich, Switzerland.

出版信息

Nat Biotechnol. 2022 Nov;40(11):1610-1616. doi: 10.1038/s41587-022-01354-7. Epub 2022 May 31.

Abstract

Current organ preservation methods provide a narrow window (usually <12 hours) to assess, transport and implant donor grafts for human transplantation. Here we report the transplantation of a human liver discarded by all centers, which could be preserved for several days using ex situ normothermic machine perfusion. The transplanted liver exhibited normal function, with minimal reperfusion injury and the need for only a minimal immunosuppressive regimen. The patient rapidly recovered a normal quality of life without any signs of liver damage, such as rejection or injury to the bile ducts, according to a 1-year follow up. This inaugural clinical success opens new horizons in clinical research and promises an extended time window of up to 10 days for assessment of viability of donor organs as well as converting an urgent and highly demanding surgery into an elective procedure.

摘要

目前的器官保存方法为评估、运输和植入用于人体移植的供体移植物提供了一个狭窄的时间窗口(通常<12小时)。在此,我们报告了一个被所有中心拒收的人类肝脏的移植情况,该肝脏通过体外常温机器灌注可保存数天。移植的肝脏功能正常,再灌注损伤极小,且仅需极少的免疫抑制方案。根据1年的随访,患者迅速恢复了正常的生活质量,没有任何肝损伤迹象,如排斥反应或胆管损伤。这一首次临床成功为临床研究开辟了新视野,并有望将供体器官活力评估的时间窗口延长至10天,同时将一项紧急且要求极高的手术转变为择期手术。

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