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评估一种新设备在猪肾、心、胰联合移植模型中减少器官移植二次热缺血的效果。

Evaluating a New Device for Reducing Second Warm Ischemia During Organ Transplantation in a Porcine Model of Kidney, Heart, and Pancreas Transplantation.

机构信息

The Jikei University School of Medicine, Department of Kidney Regenerative Medicine, Minato-ku, Tokyo-to, Japan; SCREEN Holdings Co, Ltd, Kyoto, Japan.

SCREEN Holdings Co, Ltd, Kyoto, Japan.

出版信息

Transplant Proc. 2023 May;55(4):997-1004. doi: 10.1016/j.transproceed.2023.03.052. Epub 2023 Apr 24.

Abstract

BACKGROUND

Second warm ischemia (SWI) injury between the completion of vascular anastomosis and graft reperfusion has been a longstanding issue in organ transplantation. This type of SWI injury is more severe in transplanted organs more sensitive to temperature changes. This study aimed to present the newly developed OrganPocket, an organ protector made from a proprietary elastomer material, and to demonstrate its efficacy in mitigating SWI injury in clinical kidney transplantation.

METHODS

We used an ex vivo porcine organ model to evaluate OrganPocket. After removal, donor organs were immersed and cryopreserved in an organ preservation solution at 4°C before being placed in an OrganPocket. The organ graft and OrganPocket were held for 30 minutes in a 37°C environment mimicking intra-abdominal conditions while temperatures were recorded. Control organs were evaluated under the same conditions without an OrganPocket. In addition, we tested OrganPocket in an intra-abdominal porcine allograft transplant model.

RESULTS

The control organ group temperature reached ≥16°C after 30 minutes, while the mean core temperature in the OrganPocket organ group remained at no more than 10°C. Despite an SWI time of approximately 30 minutes, the surface organ temperature upon removal of OrganPocket was 20°C. Cardiac grafts also exhibited a normal heartbeat after reperfusion.

CONCLUSIONS

OrganPocket is the world's first device designed to prevent SWI and should also prove useful for heart transplantation.

摘要

背景

在血管吻合完成与移植物再灌注之间的第二次热缺血(SWI)损伤一直是器官移植中的一个长期问题。这种类型的 SWI 损伤在对温度变化更敏感的移植器官中更为严重。本研究旨在介绍新开发的 OrganPocket,这是一种由专有弹性体材料制成的器官保护器,并展示其在减轻临床肾移植中 SWI 损伤的功效。

方法

我们使用离体猪器官模型来评估 OrganPocket。在去除后,供体器官被浸入器官保存液中并在 4°C 下冷冻保存,然后放入 OrganPocket 中。器官移植物和 OrganPocket 在 37°C 的环境中保持 30 分钟,模拟腹腔内的条件,同时记录温度。在相同条件下,没有 OrganPocket 的对照器官进行评估。此外,我们在腹腔内猪同种异体移植模型中测试了 OrganPocket。

结果

对照组器官的温度在 30 分钟后达到≥16°C,而 OrganPocket 器官组的核心温度平均保持在 10°C 以下。尽管 SWI 时间约为 30 分钟,但移除 OrganPocket 时器官表面温度仍为 20°C。心脏移植物在再灌注后也表现出正常的心跳。

结论

OrganPocket 是世界上第一个旨在预防 SWI 的设备,对于心脏移植也应该很有用。

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