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美国移植外科学会常温区域性灌注标准:腹部。

American Society of Transplant Surgeons Normothermic Regional Perfusion Standards: Abdominal.

机构信息

Department of Transplant, Mayo Clinic Florida, Jacksonville, FL.

Division of Transplant Surgery, Department of Surgery, University of Colorado, Aurora, CO.

出版信息

Transplantation. 2024 Aug 1;108(8):1660-1668. doi: 10.1097/TP.0000000000005114. Epub 2024 Jul 17.

Abstract

BACKGROUND

Normothermic regional perfusion (NRP) has emerged as a vital technique in organ procurement, particularly in donation after circulatory death (DCD) cases, offering the potential to optimize organ utilization and improve posttransplant outcomes. Recognizing its significance, the American Society of Transplant Surgeons (ASTS) convened a work group to develop standardized recommendations for abdominal NRP in the United States.

METHODS

The workgroup, comprising experts in NRP, DCD, and transplantation, formulated recommendations through a collaborative process involving revisions and approvals by relevant committees and the ASTS council. Four key areas were identified for standardization: Preprocedure communication, NRP procedure, Terminology and documentation, and Mentorship/credentialing.

RESULTS

The recommendations encompass a range of considerations, including preprocedure communication protocols to facilitate informed decision-making by transplant centers and organ procurement organizations, procedural guidelines for NRP teams, uniform terminology to clarify the NRP process, and standards for mentorship and credentialing of NRP practitioners. Specific recommendations address logistical concerns, procedural nuances, documentation requirements, and the importance of ongoing quality assurance.

CONCLUSIONS

The standardized recommendations for abdominal NRP presented in this article aim to ensure consistency, safety, and efficacy in the organ procurement process. By establishing clear protocols and guidelines, the ASTS seeks to enhance organ utilization, honor donor wishes, and uphold public trust in the donation process. Implementation of these recommendations can contribute to the advancement of NRP practices and improve outcomes for transplant recipients.

摘要

背景

在器官获取中,常温区域性灌注(NRP)已成为一项重要技术,特别是在心脏死亡后捐献(DCD)病例中,有潜力优化器官利用并改善移植后结果。鉴于其重要性,美国移植外科学会(ASTS)召集了一个工作组,为美国的腹部 NRP 制定标准化建议。

方法

该工作组由 NRP、DCD 和移植方面的专家组成,通过相关委员会和 ASTS 理事会的修订和批准,协作制定建议。确定了四个标准化关键领域:术前沟通、NRP 程序、术语和文件记录以及指导/认证。

结果

这些建议涵盖了一系列考虑因素,包括术前沟通协议,以促进移植中心和器官获取组织做出知情决策;NRP 团队的程序指南;统一术语,以明确 NRP 过程;以及 NRP 从业者的指导和认证标准。具体建议涉及物流问题、程序细节、文件要求以及持续质量保证的重要性。

结论

本文提出的腹部 NRP 标准化建议旨在确保器官获取过程的一致性、安全性和有效性。通过制定明确的协议和指南,ASTS 旨在提高器官利用率、尊重供者意愿,并维护公众对捐赠过程的信任。这些建议的实施有助于推进 NRP 实践并改善移植受者的结果。

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