摘要
器官移植已成为各类终末器官功能衰竭的标准治疗方法。然而,世界各国均面临严峻的器官短缺形势,迫使临床医师更多地使用扩大标准供者器官。常规的静态冷保存技术无法满足该类器官功能评估与减轻缺血损伤的要求,因此,各类体外机械灌注技术应运而生。肝脏体外机械灌注技术主要包括低温机械灌注、低温有氧机械灌注、常温机械灌注、无缺血肝移植和亚常温机械灌注等技术。近年来国内外开展的研究结果表明,体外机械灌注技术具有延长供肝保存时间、评估供肝质量、减轻缺血再灌注损伤和改善移植预后等优势。为加快肝脏体外机械灌注技术在我国的临床应用,本指南结合国内外研究结果,基于循证医学原则,从供肝获取、保存、质量评估和临床预后方面形成肝脏体外机械灌注的推荐意见。
Organ transplantation is the standard treatment for end-stage organ failure,yet severe shortages of organs persist worldwide,necessitating the use of organs from extended criteria donor.Traditional static cold storage has limitations in evaluating organ function and mitigating ischemia-reperfusion injury.Consequently,various ex situ machine perfusion techniques have been developed,including hypothermic machine perfusion,hypothermic oxygenated perfusion,normothermic machine perfusion,ischemia-free liver transplantation,and sub-normothermic machine perfusion.Recent studies demonstrate that these technologies can extend preservation time,enable liver quality assessment,reduce ischemia-reperfusion injury,and improve transplantation prognosis.This guideline aims to promote the clinical application of ex situ liver machine perfusion in China.Based on evidencebased medicine principles and recent studies,recommendations are provided on graft procurement,preservation,quality evaluation,and transplantation prognosis.
作者
中华医学会器官移植学分会
何晓顺
郭志勇
家泽华
王铁龙
王彦峰
欧阳青
张波
孙强
孙纪三
廖吉祥
潘崎
黎松明
Branch of Organ Transplantation of Chinese Medical Association;He Xiaoshun;Guo Zhiyong(不详;Organ Transplantation Center,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510062,China)
出处
《中华移植杂志(电子版)》
2024年第6期334-345,共12页
Chinese Journal of Transplantation(Electronic Edition)
基金
国家自然科学基金面上项目(81970564,82070670,82170663,82370664,82300744)。
关键词
肝移植
体外机械灌注
扩大标准供者
缺血再灌注损伤
移植预后
Liver transplantation
Ex situ machine perfusion
Extended criteria donor
Ischemia-reperfusion injury
Transplantation prognosis
