Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Curr Opin Organ Transplant. 2023 Apr 1;28(2):71-75. doi: 10.1097/MOT.0000000000001038. Epub 2022 Nov 17.
This review is intended to provide an update on the logistics, technique, and outcomes associated with normothermic regional perfusion (NRP), as well as provide a discussion of the associated ethical issues.
There has been renewed interest in utilizing NRP to increase quality and availability of organs from donation after circulatory death (DCD) donors. Our institution has increasing experience with thoraco-abdominal NRP (TA-NRP) in controlled DCD donors (cDCD), whereas abdominal NRP (A-NRP) has been used with success in both cDCD and uncontrolled DCD (uDCD). There is increasing evidence that NRP can be conducted in a practical and cost-efficient manner, and that the organ yield may be of better quality than standard direct procurement and perfusion (DPP).
NRP is increasingly successful and will likely prove to be a superior method for cDCD recovery. However, before TA-NRP can be widely accepted the ethical debate surrounding this technique must be settled.
本综述旨在提供有关常温区域性灌注（NRP）的后勤、技术和结果的最新信息，并讨论相关的伦理问题。
人们对利用 NRP 增加捐赠后循环死亡（DCD）供体器官的质量和可用性重新产生了兴趣。我们机构在控制性 DCD 供体（cDCD）中使用胸腹腔 NRP（TA-NRP）的经验不断增加，而腹腔 NRP（A-NRP）已成功用于 cDCD 和不受控制的 DCD（uDCD）。越来越多的证据表明，NRP 可以以实用且具有成本效益的方式进行，并且其器官产量可能比标准直接采购和灌注（DPP）更好。
NRP 越来越成功，并且可能被证明是 cDCD 恢复的更好方法。然而，在 TA-NRP 被广泛接受之前，必须解决围绕该技术的伦理争议。
