Saint Louis University, St. Louis, MO, USA.
Department of Pediatrics, SSM Saint Louis University School of Medicine, Saint Louis, MO, USA.
Int J Artif Organs. 2023 Dec;46(12):618-628. doi: 10.1177/03913988231207719. Epub 2023 Oct 28.
In recent years, normothermic machine perfusion (NMP) has emerged in conversation surrounding organ preservation and transplantation techniques with the goal of improving patient and clinical outcomes. This is in great attempt to address the rate of non-utilization and the shortage of available organs in kidney transplantation. This focus in mind, normothermic perfusion presents itself as a potential tool to mimic physiological conditions and improve current preservation methods, such as static cold storage. This review serves to improve understanding of the observed connection between the consequences of ischemia and reperfusion injury and traditional preservation techniques as well as how renal NMP may mitigate these issues. Previous studies suggest that reducing time in static cold storage methods by promoting the normothermic perfusion model results in decreased delayed graft function and post-transplant complications. This review also aims to present the immense clinical potential NMP has on future kidney transplantation success and what this means for the fields of nephrology and transplantation. While great strides have been made to evaluate normothermic perfusion's impact on kidney graft viability and transplant success, future research into unified protocol, clinically relevant biomarkers, cost-utility analysis, and use with associated therapeutic and imaging modalities is paramount.
近年来，常温机器灌注（NMP）在器官保存和移植技术的讨论中崭露头角，旨在改善患者和临床结果。这是为了应对肾移植中器官利用率低和可用器官短缺的问题。有鉴于此，常温灌注本身可以作为一种模拟生理条件的潜在工具，并改进现有的保存方法，如静态冷藏。本综述旨在提高对缺血再灌注损伤的后果与传统保存技术之间的观察到的联系的理解，以及肾脏 NMP 如何减轻这些问题。先前的研究表明，通过推广常温灌注模型来减少静态冷藏方法中的时间，可以降低延迟移植物功能和移植后并发症的发生。本综述还旨在展示 NMP 在未来肾移植成功方面的巨大临床潜力，以及这对肾脏病学和移植领域的意义。尽管已经在评估常温灌注对肾移植物活力和移植成功的影响方面取得了重大进展，但未来的研究需要统一方案、临床相关生物标志物、成本效益分析以及与相关治疗和成像方式的结合。
