留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

重视供肝机械灌注研究,推动肝移植高质量发展

欧阳青 谭晓宇 霍枫

欧阳青, 谭晓宇, 霍枫. 重视供肝机械灌注研究,推动肝移植高质量发展[J]. 器官移植, 2021, 12(1): 1-7. doi: 10.3969/j.issn.1674-7445.2021.01.001
引用本文: 欧阳青, 谭晓宇, 霍枫. 重视供肝机械灌注研究,推动肝移植高质量发展[J]. 器官移植, 2021, 12(1): 1-7. doi: 10.3969/j.issn.1674-7445.2021.01.001
Ouyang Qing, Tan Xiaoyu, Huo Feng. Attaching importance to mechanical perfusion of donor liver and promoting high-quality development of liver transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(1): 1-7. doi: 10.3969/j.issn.1674-7445.2021.01.001
Citation: Ouyang Qing, Tan Xiaoyu, Huo Feng. Attaching importance to mechanical perfusion of donor liver and promoting high-quality development of liver transplantation[J]. ORGAN TRANSPLANTATION, 2021, 12(1): 1-7. doi: 10.3969/j.issn.1674-7445.2021.01.001

重视供肝机械灌注研究,推动肝移植高质量发展

doi: 10.3969/j.issn.1674-7445.2021.01.001
基金项目: 

国家自然科学基金青年项目 81800556

军队实验动物专项科研项目 SYDW(2017)12

详细信息
    作者简介:

    欧阳青,男,1985年生,博士,主治医师,研究方向为肝移植、器官捐献与维护,Email:kanshine@163.com

    霍枫,主任医师、教授,中国人民解放军南部战区总医院普通外科首席专家、第10届中国医师奖获得者。目前担任国家人体器官捐献与移植委员会委员、全军肝胆外科专业委员会副主任委员、中国医师协会器官移植医师分会常务委员、广东省器官捐献与移植质控中心副主任、广东省医学会肝胆胰外科学分会前任主任委员、中央军委保健会诊专家。率先在国内成立了器官获取组织,开展并发表体外膜肺氧合维护供者器官的流程与规范及中国公民逝世后器官捐献的流程与规范。在机械灌注保存供者器官相关研究领域进行了大量研究,积极参与并推动了我国器官移植的改革

    通讯作者:

    霍枫,Email:gzhuofeng@163.com

  • 中图分类号: R617

Attaching importance to mechanical perfusion of donor liver and promoting high-quality development of liver transplantation

More Information
  • 摘要: 随着器官捐献数量不断增加和扩大标准供者(ECD)供肝定义不断拓展,供肝质量必然成为影响肝移植高质量发展的突出问题,也是相关领域的研究重点。最大限度解决器官短缺和推动器官移植高质量发展是我国器官捐献与移植事业发展的方向。近年来,利用机械灌注(MP)对供肝进行灌注、保存、评估及修复,已成为当前国际上提高肝移植质量的研究热点。本文针对国内外ECD供肝的不同应用情况,结合国际上MP研究进展和本中心有关研究经验,探讨整合器官保护技术建设器官重症监护室(ICU)的可行性,拟在推动我国器官移植高质量发展同时,进一步丰富器官捐献与移植“中国模式”的技术内涵。
  • [1] CZIGANY Z, TACKE F, LURJE G. Evolving trends in machine liver perfusion: comments on clinical end points and selection criteria[J]. Gastroenterology, 2019, 157(4):1166-1167. DOI: 10.1053/j.gastro.2019.02.051.
    [2] WHITE SL. Nudging the organ discard problem[J]. Transplantation, 2017, 101(7):1518-1519. DOI: 10.1097/TP.0000000000001718.
    [3] NAIR A, HASHIMOTO K. Extended criteria donors in liver transplantation-from marginality to mainstream[J]. Hepatobiliary Surg Nutr, 2018, 7(5):386-388. DOI: 10.21037/hbsn.2018.06.08.
    [4] GANDOLFINI I, BUZIO C, ZANELLI P, et al. The kidney donor profile index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes[J]. Am J Transplant, 2014, 14(11):2515-2525. DOI: 10.1111/ajt.12928.
    [5] FUDIM M, DAVIS ME, JENKINS C, et al. Marginal donor use in patients undergoing heart transplantation with left ventricular assist device explantation[J]. Ann Thorac Surg, 2015, 100(6):2117-2126. DOI: 10.1016/j.athoracsur.2015.05.110.
    [6] ADAM R, KARAM V, CAILLIEZ V, et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR)-50-year evolution of liver transplantation[J]. Transpl Int, 2018, 31(12):1293-1317. DOI: 10.1111/tri.13358.
    [7] 黄洁夫.中国器官移植发展报告(2015-2018)[R].昆明: 中国器官移植发展基金会, 2019.
    [8] CZIGANY Z, LURJE I, TOLBA RH, et al. Machine perfusion for liver transplantation in the era of marginal organs-new kids on the block[J]. Liver Int, 2019, 39(2):228-249. DOI: 10.1111/liv.13946.
    [9] HERRERO TORRES MA, DOMNIGUEZ BASTANTE M, MOLINA RAYA A, et al. Eight years of extracorporeal membrane oxygenation in liver transplantation: our experience[J]. Transplant Proc, 2020, 52(2):572-574. DOI: 10.1016/j.transproceed.2019.11.050.
    [10] HAGNESS M, FOSS S, SøRENSEN DW, et al. Liver transplant after normothermic regional perfusion from controlled donors after circulatory death: the Norwegian experience[J]. Transplant Proc, 2019, 51(2):475-478. DOI: 10.1016/j.transproceed.2019.01.066.
    [11] HESSHEIMER AJ, COLL E, TORRES F, et al. Normothermic regional perfusion vs. super-rapid recovery in controlled donation after circulatory death liver transplantation[J]. J Hepatol, 2019, 70(4):658-665. DOI: 10.1016/j.jhep.2018.12.013.
    [12] CHO Y, KIM C, KANG B. Risk of bias assessment of randomised controlled trials referenced in the 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care: a cross-sectional review[J]. BMJ Open, 2019, 9(5):e023725. DOI: 10.1136/bmjopen-2018-023725.
    [13] ZHANG Y, ZHANG Y, ZHANG M, et al. Hypothermic machine perfusion reduces the incidences of early allograft dysfunction and biliary complications and improves 1-year graft survival after human liver transplantation: a Meta-analysis[J]. Medicine (Baltimore), 2019, 98(23):e16033. DOI: 10.1097/MD.0000000000016033.
    [14] KRON P, SCHLEGEL A, MANCINA L, et al. Hypothermic oxygenated perfusion (HOPE) for fatty liver grafts in rats and humans[J]. J Hepatol, 2017, 68(1):82-91. DOI: 10.1016/j.jhep.2017.08.028.
    [15] THORNE AM, UBBINK R, BRÜGGENWIRTH IMA, et al. Hyperthermia-induced changes in liver physiology and metabolism: a rationale for hyperthermic machine perfusion[J]. Am J Physiol Gastrointest Liver Physiol, 2020, 319(1):G43-G50. DOI: 10.1152/ajpgi.00101.2020.
    [16] SCHLEGEL A, MULLER X, KALISVAART M, et al. Outcomes of DCD liver transplantation using organs treated by hypothermic oxygenated perfusion before implantation[J]. J Hepatol, 2019, 70(1):50-57. DOI: 10.1016/j.jhep.2018.10.005.
    [17] MARTINS PN, BUCHWALD JE, MERGENTAL H, et al. The role of normothermic machine perfusion in liver transplantation[J]. Int J Surg, 2020, 82(Suppl):52-60. DOI: 10.1016/j.ijsu.2020.05.026.
    [18] NASRALLA D, COUSSIOS CC, MERGENTAL H, et al. A randomized trial of normothermic preservation in liver transplantation[J]. Nature, 2018, 557(7703):50-56. DOI: 10.1038/s41586-018-0047-9.
    [19] ESHMUMINOV D, BECKER D, BAUTISTA BORREGO L, et al. An integrated perfusion machine preserves injured human livers for 1 week[J]. Nat Biotechnol, 2020, 38(2):189-198. DOI: 10.1038/s41587-019-0374-x.
    [20] VON HORN C, BABA HA, HANNAERT P, et al. Controlled oxygenated rewarming up to normothermia for pretransplant reconditioning of liver grafts[J]. Clin Transplant, 2017, 31(11). DOI: 10.1111/ctr.13101.
    [21] DE VRIES Y, MATTON APM, NIJSTEN MWN, et al. Pretransplant sequential hypo- and normothermic machine perfusion of suboptimal livers donated after circulatory death using a hemoglobin-based oxygen carrier perfusion solution[J]. Am J Transplant, 2019, 19(4):1202-1211. DOI: 10.1111/ajt.15228.
    [22] DENGU F, ABBAS SH, EBELING G, et al. Normothermic machine perfusion (NMP) of the liver as a platform for therapeutic interventions during ex-vivo liver preservation: a review[J]. J Clin Med, 2020, 9(4):1046. DOI: 10.3390/jcm9041046.
    [23] FENG S, GOODRICH NP, BRAGG-GRESHAM JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index[J]. Am J Transplant, 2006, 6(4):783-790. DOI: 10.1111/j.1600-6143.2006.01242.x.
    [24] WINTER A, FÉRAY C, AUDUREAU E, et al. A donor quality index for liver transplantation: development, internal and external validation[J]. Sci Rep, 2018, 8(1): 9871. DOI: 10.1038/s41598-018-27960-7.
    [25] SCHLEGEL A, KALISVAART M, SCALERA I, et al. The UK DCD risk score: a new proposal to define futility in donation-after-circulatory-death liver transplantation[J]. J Hepatol, 2018, 68(3):456-464. DOI: 10.1016/j.jhep.2017.10.034.
    [26] DE MEIJER VE, FUJIYOSHI M, PORTE RJ. Ex situ machine perfusion strategies in liver transplantation[J]. J Hepatol, 2019, 70(1):203-205. DOI: 10.1016/j.jhep. 2018.09.019.
    [27] BHOGAL RH, MIRZA DF, AFFORD SC, et al. Biomarkers of liver injury during transplantation in an era of machine perfusion[J]. Int J Mol Sci, 2020, 21(5):1578. DOI: 10.3390/ijms21051578.
    [28] MATTON APM, DE VRIES Y, BURLAGE LC, et al. Biliary bicarbonate, pH, and glucose are suitable biomarkers of biliary viability during ex situ normothermic machine perfusion of human donor livers[J]. Transplantation, 2019, 103(7):1405-1413. DOI: 10.1097/TP.0000000000002500.
    [29] WATSON CJE, KOSMOLIAPTSIS V, PLEY C, et al. Observations on the ex situ perfusion of livers for transplantation[J]. Am J Transplant, 2018, 18(8):2005-2020. DOI: 10.1111/ajt.14687.
    [30] SCHREITER T, SOWA JP, SCHLATTJAN M, et al. Human ex-vivo liver model for acetaminophen-induced liver damage[J]. Sci Rep, 2016, 6:31916. DOI: 10.1038/srep31916.
  • 加载中
计量
  • 文章访问数:  63
  • HTML全文浏览量:  39
  • PDF下载量:  29
  • 被引次数: 0
出版历程
  • 收稿日期:  2020-11-02
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2021-01-19

目录

    /

    返回文章
    返回