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肾移植中实施常温机器灌注的机遇与挑战。

Opportunities and challenges with the implementation of normothermic machine perfusion in kidney transplantation.

作者信息

Rabelink Ton J, Hosgood Sarah, Minor Thomas, Selzner Markus, Weissenbacher Annemarie, Leuvenink Henri Gd, Schneeberger Stefan

机构信息

Department of Medicine and Transplant Center, Leiden University Medical Center, Leiden, The Netherlands.

Department of Surgery, University of Cambridge. Addenbrooke's Hospital. Level 9. CB2 0QQ, Cambridge, UK.

出版信息

Nat Commun. 2025 Jul 25;16(1):6883. doi: 10.1038/s41467-025-60410-3.

DOI:10.1038/s41467-025-60410-3
PMID:40715058
Abstract

End stage kidney disease and dialysis are lifetime limiting and lifestyle-defining conditions with enormous costs to the health care system. Despite a severe organ shortage, thousands of organs that are retrieved for transplantation go to waste every year because of the presumed inadequacy of organ quality and/or the limited organ preservation time. Normothermic kidney machine perfusion (NMP) holds the potential to resolve this through improved preservation, prolonged preservation time, kidney quality assessment, reconditioning and treatment. We herein develop a perspective on the potential, but also the hurdles towards the breakthrough of this technology.

摘要

终末期肾病和透析是限制生命且定义生活方式的病症,给医疗保健系统带来巨大成本。尽管器官严重短缺,但由于假定的器官质量不足和/或器官保存时间有限,每年数千个获取用于移植的器官被浪费。常温肾脏机器灌注(NMP)有潜力通过改善保存、延长保存时间、肾脏质量评估、修复和治疗来解决这一问题。我们在此阐述了这项技术取得突破的潜力以及面临的障碍。

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Opportunities and challenges with the implementation of normothermic machine perfusion in kidney transplantation.肾移植中实施常温机器灌注的机遇与挑战。
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本文引用的文献

1
Normothermic human kidney preservation drives iron accumulation and ferroptosis.常温下人肾保存会促使铁蓄积和铁死亡。
Nat Commun. 2025 Jul 1;16(1):5420. doi: 10.1038/s41467-025-61058-9.
2
Assessing donor kidney function: the role of CIRBP in predicting delayed graft function post-transplant.评估供体肾功能:CIRBP在预测移植后移植肾功能延迟恢复中的作用。
Front Immunol. 2025 Jan 17;15:1518279. doi: 10.3389/fimmu.2024.1518279. eCollection 2024.
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Normothermic Liver Machine Perfusion at a Large European Center: Real-world Outcomes following 238 Applications.
欧洲一家大型中心的常温肝脏机器灌注:238例应用后的实际结果
Ann Surg. 2025 May 1;281(5):872-883. doi: 10.1097/SLA.0000000000006634. Epub 2025 Jan 20.
4
Cortex kidney tissue partial oxygen pressure depends on percentage of active oxygenation during oxygenated hypothermic machine perfusion.肾皮质组织局部氧分压取决于低温氧合机器灌注期间的活性氧合百分比。
Artif Organs. 2025 Apr;49(4):600-614. doi: 10.1111/aor.14916. Epub 2024 Dec 6.
5
Normothermic Ex Vivo Perfusion Before Transplantation of the Kidney (NEXT-Kidney): A Single-center, Nonrandomized Feasibility Study.肾脏移植前常温体外灌注(NEXT-肾脏):一项单中心、非随机可行性研究。
Transplantation. 2025 May 1;109(5):881-889. doi: 10.1097/TP.0000000000005233. Epub 2025 Apr 17.
6
Governing new technologies that stop biological time: Preparing for prolonged biopreservation of human organs in transplantation.管理阻止生物时间的新技术:为移植中人类器官的长期生物保存做准备。
Am J Transplant. 2025 Feb;25(2):269-276. doi: 10.1016/j.ajt.2024.09.017. Epub 2024 Sep 19.
7
How DNA Sensing Drives Inflammation.DNA 传感如何驱动炎症反应。
N Engl J Med. 2024 Oct 17;391(15):1456-1458. doi: 10.1056/NEJMcibr2410049. Epub 2024 Sep 19.
8
Normothermic ex vivo kidney perfusion preserves mitochondrial and graft function after warm ischemia and is further enhanced by AP39.常温离体肾脏灌注在热缺血后能保持线粒体和移植物功能,AP39 进一步增强了这一作用。
Nat Commun. 2024 Sep 15;15(1):8086. doi: 10.1038/s41467-024-52140-9.
9
A cell-free nutrient-supplemented perfusate allows four-day ex vivo metabolic preservation of human kidneys.无细胞营养补充灌流液可实现人类肾脏离体 4 天代谢保存。
Nat Commun. 2024 May 13;15(1):3818. doi: 10.1038/s41467-024-47106-w.
10
Chronic kidney disease and the global public health agenda: an international consensus.慢性肾脏病与全球公共卫生议程:国际共识。
Nat Rev Nephrol. 2024 Jul;20(7):473-485. doi: 10.1038/s41581-024-00820-6. Epub 2024 Apr 3.