Ran Qiulin, Zhang Jiayi, Zhong Jisheng, Lin Ji, Zhang Shuai, Li Guang, You Bin
Department of Cardiovascular Surgery, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Translational Medicine Center, Beijing Chest Hospital, Capital Medical University, Beijing, China.
Front Med (Lausanne). 2025 Mar 26;12:1566080. doi: 10.3389/fmed.2025.1566080. eCollection 2025.
Despite the annual rise in patients with end-stage diseases necessitating organ transplantation, the scarcity of high-quality grafts constrains the further development of transplantation. The primary causes of the graft shortage are the scarcity of standard criteria donors, unsatisfactory organ preservation strategies, and mismatching issues. Organ preservation strategies are intimately related to pre-transplant graft viability and the incidence of adverse clinical outcomes. Static cold storage (SCS) is the current standard practice of organ preservation, characterized by its cost-effectiveness, ease of transport, and excellent clinical outcomes. However, cold-induced injury during static cold preservation, toxicity of organ preservation solution components, and post-transplantation reperfusion injury could further exacerbate graft damage. Long-term dynamic machine perfusion (MP) preserves grafts in a near-physiological condition, evaluates graft viability, and cures damage to grafts, hence enhancing the usage and survival rates of marginal organs. With the increased use of extended criteria donors (ECD) and advancements in machine perfusion technology, static cold storage is being gradually replaced by machine perfusion. This review encapsulates the latest developments in cryopreservation, subzero non-freezing storage, static cold storage, and machine perfusion. The emphasis is on the injury mechanisms linked to static cold storage and optimization strategies, which may serve as references for the optimization of machine perfusion techniques.
尽管每年需要器官移植的终末期疾病患者数量在增加，但高质量移植物的稀缺限制了移植技术的进一步发展。移植物短缺的主要原因是标准标准供体的稀缺、器官保存策略不尽人意以及配型问题。器官保存策略与移植前移植物的活力以及不良临床结局的发生率密切相关。静态冷藏（SCS）是目前器官保存的标准做法，其特点是成本效益高、运输方便且临床效果良好。然而，静态冷藏期间的冷诱导损伤、器官保存溶液成分的毒性以及移植后再灌注损伤可能会进一步加重移植物损伤。长期动态机器灌注（MP）可在接近生理条件下保存移植物，评估移植物活力，并修复移植物损伤，从而提高边缘器官的利用率和存活率。随着扩展标准供体（ECD）的使用增加以及机器灌注技术的进步，静态冷藏正逐渐被机器灌注所取代。本综述总结了冷冻保存、零下非冷冻保存、静态冷藏和机器灌注的最新进展。重点是与静态冷藏相关的损伤机制和优化策略，可为机器灌注技术的优化提供参考。
