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常温区域灌注是心脏移植中循环性死亡后器官捐献(DCD)的一种新兴的具有成本效益的替代方案。

Normothermic Regional Perfusion is an Emerging Cost-Effective Alternative in Donation After Circulatory Death (DCD) in Heart Transplantation.

作者信息

Alamouti-Fard Emad, Garg Pankaj, Wadiwala Ishaq J, Yazji John H, Alomari Mohammad, Hussain Md Walid Akram, Elawady Mohamed S, Jacob Samuel

机构信息

Cardiothoracic Surgery, Mayo Clinic, Jacksonville, USA.

Colorectal Surgery, Mayo Clinic, Jacksonville, USA.

出版信息

Cureus. 2022 Jun 29;14(6):e26437. doi: 10.7759/cureus.26437. eCollection 2022 Jun.

Abstract

In donation after circulatory death (DCD) organ transplantation, normothermic regional perfusion (NRP) restores oxygenated blood flow following cardiac arrest and reverses warm ischemia. Recently, NRP has also been used to help recover DCD hearts in addition to the abdominal organs. While DCD donation has increased the number of abdominal organs and lungs pool, it has not been able to increase the number of heart transplants, despite the fact that it has the potential to increase the number of heart transplants by 15-30%. Thoracoabdominal normothermic regional perfusion makes heart transplantation feasible and permits assessing heart function before an organ procurement without affecting the preservation of abdominal organs. NRP can be used in two ways for DCD donor heart transplants: normothermic regional perfusion followed by machine perfusion (NRP-MP) and normothermic regional perfusion followed by static cold storage (NRP-SCS). Normothermic regional perfusion is an emerging technology, a cost-effective alternative in donation after circulatory death (DCD), and will increase the pool of donors in heart transplantation.

摘要

在心脏死亡后器官捐献(DCD)的器官移植中,常温区域灌注(NRP)可在心脏骤停后恢复氧合血流并逆转热缺血。最近,除了腹部器官外,NRP还被用于帮助恢复DCD心脏。虽然DCD捐献增加了腹部器官和肺的供体库数量,但尽管其有可能将心脏移植数量增加15%至30%,却未能增加心脏移植的数量。胸腹常温区域灌注使心脏移植成为可能,并允许在器官获取前评估心脏功能,而不影响腹部器官的保存。NRP可通过两种方式用于DCD供体心脏移植:常温区域灌注后机器灌注(NRP-MP)和常温区域灌注后静态冷藏(NRP-SCS)。常温区域灌注是一项新兴技术,是心脏死亡后器官捐献(DCD)中一种具有成本效益的替代方法,将增加心脏移植的供体库。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0645/9246458/34f9c7a687aa/cureus-0014-00000026437-i01.jpg

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