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肝脏移植机械灌注:从历史角度到移植手术的现代方法。

Liver Graft Machine Perfusion: From History Perspective to Modern Approaches in Transplant Surgery.

机构信息

>From the National Children's Medical Center Tashkent, Uzbekistan.

出版信息

Exp Clin Transplant. 2024 Jul;22(7):497-508. doi: 10.6002/ect.2024.0137.

Abstract

The shortage of donor organs remains an unresolved issue in livertransplantation worldwide. Consequently, strategies for expanding the donor pool are currently being developed. Donors meeting extended criteria undergo thorough evaluation, as livers obtained from marginal donors yield poorer outcomes in recipients, including exacerbated reperfusion injury, acute kidney injury, early graft dysfunction, and primary nonfunctioning graft. However, the implementation of machine perfusion has shown excellent potential in preserving donor livers and improving their characteristics to achieve better outcomes for recipients. In this review, we analyzed the global experience of using machine perfusion in livertransplantation through the history ofthe development ofthis method to the latest trends and possibilities for increasing the number of liver transplants.

摘要

供体器官短缺仍然是全球肝移植领域尚未解决的问题。因此,目前正在制定扩大供体库的策略。符合扩展标准的供体需要进行全面评估,因为来自边缘供体的肝脏会导致受体的预后更差,包括加重再灌注损伤、急性肾损伤、早期移植物功能障碍和原发性无功能移植物。然而,机器灌注的应用已显示出在保存供体肝脏和改善其特性方面具有巨大潜力,以实现受体更好的效果。在这篇综述中,我们通过该方法的发展历史分析了全球范围内在肝移植中使用机器灌注的经验,以及增加肝移植数量的最新趋势和可能性。

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