基于纳米颗粒的肝移植干预措施。
Nanoparticle-Based Interventions for Liver Transplantation.
机构信息
Division of Solid Organ Transplantation, Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
Schulze Diabetes Institute, Department of Surgery, University of Minnesota, Minneapolis, MN 55455, USA.
出版信息
Int J Mol Sci. 2023 Apr 19;24(8):7496. doi: 10.3390/ijms24087496.
Liver transplantation is the only treatment for hepatic insufficiency as a result of acute and chronic liver injuries/pathologies that fail to recover. Unfortunately, there remains an enormous and growing gap between organ supply and demand. Although recipients on the liver transplantation waitlist have significantly higher mortality, livers are often not allocated because they are (i) classified as extended criteria or marginal livers and (ii) subjected to longer cold preservation time (>6 h) with a direct correlation of poor outcomes with longer cold ischemia. Downregulating the recipient's innate immune response to successfully tolerate a graft having longer cold ischemia times or ischemia-reperfusion injury through induction of immune tolerance in the graft and the host would significantly improve organ utilization and post-transplant outcomes. Broadly, technologies proposed for development aim to extend the life of the transplanted liver through post-transplant or recipient conditioning. In this review, we focus on the potential benefits of nanotechnology to provide unique pre-transplant grafting and recipient conditioning of extended criteria donor livers using immune tolerance induction and hyperthermic pre-conditioning.
肝移植是治疗因急性和慢性肝损伤/病变而导致的肝功能不全的唯一方法,如果这些损伤/病变无法恢复。不幸的是,器官供应和需求之间仍然存在巨大且不断扩大的差距。尽管肝移植候补名单上的受者死亡率显著更高,但由于以下原因,肝脏通常无法分配:(i) 被归类为扩展标准或边缘供肝,(ii) 冷保存时间较长(>6 小时),与冷缺血时间延长直接相关,预后较差。通过在移植物和宿主中诱导免疫耐受来下调受者的固有免疫反应,以成功耐受具有较长冷缺血时间或缺血再灌注损伤的移植物,将显著提高器官利用率和移植后结果。总的来说,为了延长移植肝的寿命而提出的技术旨在通过移植后或受者调理来实现。在这篇综述中,我们重点介绍了纳米技术的潜在益处,该技术可通过诱导免疫耐受和高热预处理,为扩展标准供体肝脏提供独特的移植前供体和受者调理。
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