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直接灌注及获取肺脏联合腹部常温区域灌注时的血液保护技术

Technique of blood conservation in direct perfusion and procurement of lungs in combination with abdominal normothermic regional perfusion.

作者信息

Mohite Prashant N, Messer Simon, Curry Philip

机构信息

Department of Cardiac Surgery and Transplantation, Golden Jubilee National Hospital, Clydebank, Glasgow, United Kingdom.

出版信息

JHLT Open. 2024 Mar 20;4:100087. doi: 10.1016/j.jhlto.2024.100087. eCollection 2024 May.

DOI:10.1016/j.jhlto.2024.100087
PMID:40144261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11935492/
Abstract

Utilization of abdominal-normothermic regional perfusion (A-NRP) for organ procurement in donation after circulatory death is becoming commonplace. Simultaneous procurement of the donor lungs is technically challenging due to blood loss in the chest leading to inadequate circulatory support to the abdominal organs. We describe a priority-based stepwise approach to minimize blood loss in the chest and conserve blood that can be utilized for the A-NRP.

摘要

在循环性死亡后供体器官获取中，利用腹部常温区域灌注（A-NRP）已变得越来越普遍。由于胸部失血导致对腹部器官的循环支持不足，同时获取供体肺在技术上具有挑战性。我们描述了一种基于优先级的逐步方法，以尽量减少胸部失血并保存可用于A-NRP的血液。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b4/11935492/fdd09353a3f7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b4/11935492/fdd09353a3f7/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6b4/11935492/fdd09353a3f7/gr1.jpg

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本文引用的文献

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Outcomes of lung and liver transplantation after simultaneous recovery using abdominal normothermic regional perfusion in donors after the circulatory determination of death versus donors after brain death.在循环判定死亡供体与脑死亡供体中，采用腹部常温区域灌注同时复苏后，肺和肝移植的结局。
Am J Transplant. 2023 Jul;23(7):996-1008. doi: 10.1016/j.ajt.2023.04.016. Epub 2023 Apr 24.
2
Lung transplantation from controlled donation after circulatory death using simultaneous abdominal normothermic regional perfusion: A single center experience.使用同时进行的腹部常温区域性灌注的控制性死后循环捐献供者行肺移植：单中心经验。
Am J Transplant. 2022 Jul;22(7):1852-1860. doi: 10.1111/ajt.17057. Epub 2022 Apr 18.
3
A systematic review and meta-analyses of regional perfusion in donation after circulatory death solid organ transplantation.
在循环死亡后实体器官移植中区域性灌注的系统评价和荟萃分析。
Transpl Int. 2021 Nov;34(11):2046-2060. doi: 10.1111/tri.14121. Epub 2021 Oct 19.
4
Effect on the donor lungs of using abdominal normothermic regional perfusion in controlled donation after circulatory death.
Eur J Cardiothorac Surg. 2020 Nov 23. doi: 10.1093/ejcts/ezaa398.
5
Combined lung and liver procurement in controlled donation after circulatory death using normothermic abdominal perfusion. Initial experience in two Spanish centers.使用常温腹部灌注在循环死亡后进行可控捐赠中联合获取肺和肝脏。西班牙两个中心的初步经验。
Am J Transplant. 2020 Jan;20(1):231-240. doi: 10.1111/ajt.15520. Epub 2019 Jul 29.
6
Direct Procurement of Donor Heart With Normothermic Regional Perfusion of Abdominal Organs.常温下腹部器官区域灌注下的供心直接获取。
Ann Thorac Surg. 2019 Aug;108(2):597-600. doi: 10.1016/j.athoracsur.2019.01.087. Epub 2019 Mar 23.
7
In situ normothermic perfusion of livers in controlled circulatory death donation may prevent ischemic cholangiopathy and improve graft survival.在控制性循环死亡供肝中进行原位常温灌流可能预防缺血性胆管病并提高移植物存活率。
Am J Transplant. 2019 Jun;19(6):1745-1758. doi: 10.1111/ajt.15241. Epub 2019 Feb 1.