Silpe Stephanie, Martinez Eric, Wall Anji
Baylor University Medical Center, Dallas, Texas, USA.
Curr Opin Organ Transplant. 2024 Jun 1;29(3):200-204. doi: 10.1097/MOT.0000000000001140. Epub 2024 Mar 11.
Normothermic regional perfusion (NRP) is a novel procurement technique for donation after circulatory death (DCD) in the United States. It was pioneered by cardiothoracic surgery programs and is now being applied to abdominal-only organ donors by abdominal transplant programs. Multiple technical approaches can be used for abdominal-only NRP DCD donors and this review describes these techniques.
NRP has been associated with higher utilization of organs, particularly liver and heart grafts, from DCD donors and with better recipient outcomes. There are lower rates of delayed graft function in kidney transplant recipients and lower rates of ischemic cholangiopathy in liver transplant recipients. These benefits are driving increased interest from abdominal transplant programs in using NRP for DCD procurements.
This paper describes the technical aspects of NRP DCD that allow for maximization of its use based on different donor and policy characteristics.
在美国,常温局部灌注(NRP)是一种用于循环死亡后器官捐献(DCD)的新型获取技术。它由心胸外科项目开创,目前腹部移植项目正将其应用于仅腹部器官捐献者。多种技术方法可用于仅腹部的NRP DCD捐献者,本综述将描述这些技术。
NRP与DCD捐献者器官利用率提高相关,尤其是肝脏和心脏移植物,且受体预后更好。肾移植受者延迟性移植物功能障碍发生率较低,肝移植受者缺血性胆管病发生率较低。这些益处促使腹部移植项目对使用NRP进行DCD获取的兴趣增加。
本文描述了NRP DCD的技术方面,以便根据不同的捐献者和政策特点最大限度地利用该技术。