Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria.
Oxford Transplant Centre, Nuffield Department of Surgical Sciences, University of Oxford, Oxford.
Curr Opin Organ Transplant. 2022 Oct 1;27(5):446-453. doi: 10.1097/MOT.0000000000001003. Epub 2022 Jul 15.
This review aims to summarize the latest original preclinical and clinical articles in the setting of normothermic machine perfusion (NMP) of kidney grafts.
Kidney NMP can be safely translated into the clinical routine and there is increasing evidence that NMP may be beneficial in graft preservation especially in marginal kidney grafts. Due to the near-physiological state during NMP, this technology may be used as an ex-vivo organ assessment and treatment platform. There are reports on the application of mesenchymal stromal/stem cells, multipotent adult progenitor cells and microRNA during kidney NMP, with first data indicating that these therapies indeed lead to a decrease in inflammatory response and kidney injury. Together with the demonstrated possibility of prolonged ex-vivo perfusion without significant graft damage, NMP could not only be used as a tool to perform preimplant graft assessment. Some evidence exists that it truly has the potential to be a platform to treat and repair injured kidney grafts, thereby significantly reducing the number of declined organs.
Kidney NMP is feasible and can potentially increase the donor pool not only by preimplant graft assessment, but also by ex-vivo graft treatment.
本文旨在总结常温机器灌注（NMP）在肾移植中的最新原始临床前和临床研究。
肾 NMP 可安全转化为临床常规，越来越多的证据表明，NMP 可能有益于保存移植物，特别是边缘供肾。由于 NMP 期间接近生理状态，该技术可用作器官评估和治疗的体外平台。有报道称，间充质基质/干细胞、多能成体祖细胞和 microRNA 在肾 NMP 中的应用，初步数据表明这些治疗方法确实可减少炎症反应和肾损伤。与体外长时间灌注而不显著损害移植物的可能性相结合，NMP 不仅可用于进行移植前移植物评估，还可能成为治疗和修复受损移植物的平台，从而显著减少衰竭器官的数量。
肾 NMP 可行，不仅可通过移植前移植物评估增加供体库，还可通过体外移植物处理来增加。
