切换至 "中华医学电子期刊资源库"

中华移植杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 83 -86. doi: 10.3877/cma.j.issn.1674-3903.2020.02.005

所属专题: 文献

器官捐献

推动体外器官灌注技术发展,提高捐献器官利用率及质量
李建辉1, 乔银标1, 贾俊君1, 江文诗2, 谢海洋3, 周琳3, 郑树森4,()   
  1. 1. 310003 杭州,浙江大学医学院附属第一医院肝胆胰外科
    2. 518054 深圳,国际器官捐献与移植注册
    3. 310003 杭州,浙江大学医学院附属第一医院卫生部多器官联合移植研究重点实验室
    4. 310003 杭州,浙江大学医学院附属第一医院肝胆胰外科;310003 杭州,浙江大学医学院附属第一医院卫生部多器官联合移植研究重点实验室
  • 收稿日期:2019-07-25 出版日期:2020-04-25
  • 通信作者: 郑树森
  • 基金资助:
    青年科学家专题项目(2015AA020923); 国家自然科学基金面上项目(81470891); 浙江省科技厅公益项目(2016C33145); 浙江省卫生技术项目(2020KY126); 海南省重大科技计划项目(ZDKJ2019009)

Advancing extracorporeal organ perfusion technology and improving the utilization and quality of donor organs

Jianhui Li1, Yinbiao Qiao1, Junjun Jia1, Wenshi Jiang2, Haiyang Xie3, Lin Zhou3, Shusen Zheng4,()   

  1. 1. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
    2. International Registry on Organ Donation and Transplantation, Shenzhen 518054, China
    3. Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
    4. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
  • Received:2019-07-25 Published:2020-04-25
  • Corresponding author: Shusen Zheng
  • About author:
    Corresponding author: Zheng Shunshen, Email:
引用本文:

李建辉, 乔银标, 贾俊君, 江文诗, 谢海洋, 周琳, 郑树森. 推动体外器官灌注技术发展,提高捐献器官利用率及质量[J]. 中华移植杂志(电子版), 2020, 14(02): 83-86.

Jianhui Li, Yinbiao Qiao, Junjun Jia, Wenshi Jiang, Haiyang Xie, Lin Zhou, Shusen Zheng. Advancing extracorporeal organ perfusion technology and improving the utilization and quality of donor organs[J]. Chinese Journal of Transplantation(Electronic Edition), 2020, 14(02): 83-86.

器官移植是目前治疗终末期器官衰竭唯一有效的方法,供器官来源短缺严重阻碍器官移植的发展。提高边缘供者供器官使用率可部分缓解器官来源短缺现状。随着器官保存技术的不断发展,机械灌注逐渐成为提高供器官质量的重要研究方向。机械灌注有望成为优于传统静态冷保存的器官保存技术,可改善体外供器官保存环境并提供供器官质量评估体系,更好地修复边缘供者供器官,提高供器官利用率。本文概述器官保存技术的发展历程、研究进展和未来趋势,通过医工融合,共同推动机械灌注技术发展,提高捐献器官质量及利用率。

Organ transplantation is the only effective treatment for end-stage diseases, and the scarcity of donor organ seriously hinders the development of organ transplantation. Increasing the utilization rate of marginal organs can partially alleviate the shortage of organs. With the continuous development of organ preservation technology, machine perfusion has gradually become an crucial research direction to improve the quality of donor organs. Machine perfusion is expected to be superior organ preservation technology than static cold storage and improves preservation environment and quality assessment system of the isolated donor organ, repairs marginal donor organs and improves organ utilization. We review the research progress of machine perfusion technology and the future development, through the fusion of medicine and engineering, the development of machine perfusion technology will improve the quality and utilization rate of donor organs.

[1]
Wijnen RM, Booster MH, Stubenitsky BM, et al. Outcome of transplantation of non-heart-beating donor kidneys[J]. Lancet, 1995, 345(8957): 1067-1070.
[2]
Aubert O, Kamar N, Vernerey D, et al. Long term outcomes of transplantation using kidneys from expanded criteria donors: prospective, population based cohort study[J]. BMJ, 2015, 351: h3557.
[3]
Irish WD, Ilsley JN, Schnitzler MA, et al. A risk prediction model for delayed graft function in the current era of deceased donor renal transplantation[J]. Am J Transplant, 2010, 10(10): 2279-2286.
[4]
Cho YW, Terasaki PI, Cecka JM, et al. Transplantation of kidneys from donors whose hearts have stopped beating[J]. N Engl J Med, 1998, 338(4): 221-225.
[5]
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, 2010, 6(4): 783-790.
[6]
Jia JJ, Li JH, Yu H, et al. Machine perfusion for liver transplantation: A concise review of clinical trials[J]. Hepatobiliary Pancreat Dis Int, 2018, 17(5): 387-391.
[7]
Nasralla D, Coussios CC, Mergental H, et al. A randomized trial of normothermic preservation in liver transplantation[J]. Nature, 2018, 557(7703): 50-56.
[8]
Yuan X, Theruvath AJ, Ge X, et al. Machine perfusion or cold storage in organ transplantation: indication, mechanisms, and future perspectives[J]. Transpl Int, 2010, 23(6): 561-570.
[9]
Lindbergh CA. An apparatus for the culture of whole organs[J]. J Exp Med, 1935, 62(3): 409-431.
[10]
Carrel A. Landmark article, Nov 14, 1908: Results of the transplantation of blood vessels, organs and limbs. By Alexis Carrel[J]. JAMA, 1983, 250(7): 944-953.
[11]
Belzer FO, Ashby BS, Gulyassy PF, et al. Successful seventeen-hour preservation and transplantation of human-cadaver kidney[J]. N Engl J Med, 1968, 278(11): 608-610.
[12]
Brettschneider L, Daloze PM, Huguet C, et al. Successful orthotopic transplantation of liver homografts after eight to twenty-five hours preservation[J]. Surg Forum,1967, 18:376-378.
[13]
Brettschneider L, Daloze PM, Huguet C, et al. The use of combined preservation techniques for extended storage of orthotopic liver homografts[J]. Surg Gynecol Obstet, 1968, 126(2): 263-274.
[14]
Jochmans I, Akhtar MZ, Nasralla D, et al. Past, present and future of dynamic kidney and liver preservation and resuscitation[J]. Am J Transplant, 2016, 16(9): 2545-2555.
[15]
Hosgood SA, Heurn EV, Nicholson ML. Normothermic machine perfusion of the kidney: Better conditioning and repair?[J]. Transpl Int, 2015, 28(6): 657-664.
[16]
Ravikumar R, Leuvenink H, Friend PJ. Normothermic liver preservation: a new paradigm?[J]. Transpl Int, 2015, 28(6): 690-699.
[17]
Schopp I, Reissberg E, Lüer B, et al. Controlled rewarming after hypothermia: adding a new principle to renal preservation[J]. Clin Transl Sci, 2015, 8(5): 475-478.
[18]
Dutkowski P, Polak WG, Muiesan P, et al. First comparison of hypothermic oxygenated perfusion versus static cold storage of human donation after cardiac death liver transplants: an international-matched case analysis[J]. Ann Surg, 2015, 262(5): 764-770.
[19]
Czigany Z, Schöning Wenzel, Ulmer TF, et al. Hypothermic oxygenated machine perfusion (HOPE) for orthotopic liver transplantation of human liver allografts from extended criteria donors (ECD) in donation after brain death (DBD): a prospective multicentre randomised controlled trial (HOPE ECD-DBD)[J]. BMJ Open, 2017, 7(10):e017558.
[20]
De Vries RJ, Tessier SN, Banik PD, et al. Supercooling extends preservation time of human livers[J]. Nat Biotechnol, 2019, 37(10): 1131-1136.
[21]
Que W, Hu X, Fujino M, et al. Prolonged cold ischemia time in mouse heart transplantation using supercooling preservation[J]. Transplantation, 2019. [Epub ahead of print]
[22]
Cypel M, Yeung J, Liu M, et al. Normothermic ex vivo lung perfusion in clinical lung transplantation[J]. N Eng J Med, 2011, 364(5): 1431-1440.
[23]
Liu Q, Nassar A, Farias K, et al. Comparing normothermic machine perfusion preservation with different perfusates on porcine livers from donors after circulatory death[J]. Am J Transplant, 2016, 16(3): 794-807.
[24]
李建辉,贾俊君,谢海洋,等. 一种离体肝脏灌流系统:中国,CN205357948U[P]. 2016-07-06[2019-07-10].
[25]
Eltzschig HK, Eckle T. Ischemia and reperfusion-from mechanism to translation[J]. Nat Med, 2011, 17(11): 1391-1401.
[26]
Stefan S. Life of a liver awaiting transplantation[J]. Nature, 2018, 557(7703): 40-41.
[27]
Zhang ZB, Gao W, Liu L, et al. Normothermic machine perfusion protects against liver ischemia-reperfusion injury during reduced-size liver transplantation in pigs[J]. Ann Transplant, 2019, 24: 9-17.
[28]
Kemmner S, Bachmann Q. Normothermic machine perfusion may prevent regulated cell death following renal ischemia-reperfusion injury[J]. Am J Transplant, 2019, 19(4):1245.
[29]
Valapour M, Skeans MA, Heubner BM, et al. OPTN/SRTR 2013 Annual Data Report: Lung[J]. Am J Transplant, 2015, 15(Suppl 2): S1-S28.
[30]
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.
[31]
Schlegel A, Dutkowski P. Impact of machine perfusion on biliary complications after liver transplantation[J]. Int J Mol Sci, 2018, 19(11): E3567.
[32]
Guarrera JV, Henry SD, Samstein B, et al. Hypothermic machine preservation facilitates successful transplantation of 'orphan’ extended criteria donor livers[J]. Am J Transplant, 2015, 15(1): 161-169.
[1] 史孟杰, 贺仕才, 刘斐, 闫燕, 代毅, 王辉. 对miR-206在大鼠下肢缺血再灌注损伤过程中炎症反应的影响分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(03): 249-255.
[2] 张秀杨, 张龙飞, 陈世远, 高涌. 缺氧诱导因子1α介导单羧酸转运蛋白1表达参与短链脂肪酸对肠道缺氧保护作用的研究[J]. 中华普通外科学文献(电子版), 2023, 17(01): 18-23.
[3] 江文诗, 何湘湘. 全球及我国器官捐献发展特征分析与学科建设[J]. 中华移植杂志(电子版), 2023, 17(05): 280-286.
[4] 叶啟发, 兰佳男. 中国人体器官捐献与异种移植[J]. 中华移植杂志(电子版), 2023, 17(04): 221-226.
[5] 吴建永. 单中心2 000例心脏死亡器官捐献肾移植发展与创新[J]. 中华移植杂志(电子版), 2023, 17(04): 0-.
[6] 刘剑戎, 范明明, 郭煜. 器官捐献者转介时的临床特征分析[J]. 中华移植杂志(电子版), 2023, 17(03): 129-133.
[7] 杨博尧, 陈胜峰, 崔梦一, 贾志博, 宋翔宇, 王恺, 陈蕾佳, 彭熙为, 刘亚荣, 梁西孝, 许文静, 许猛, 彭江. 异种红细胞联合膜式氧合灌注装置对人断肢离体机械灌注效果观察[J]. 中华移植杂志(电子版), 2023, 17(03): 152-157.
[8] 白玲, 陈国振, 祝锦江, 刘海平, 丁晨光, 王华. 专职器官获取护士工作的初步探索[J]. 中华移植杂志(电子版), 2023, 17(02): 94-97.
[9] 王璐, 施辉波, 曾梦君, 李小勤, 张波, 徐晶, 吴星, 蒋继贫, 陈知水. 人体捐献器官获取全流程远程交互系统的设计与应用[J]. 中华移植杂志(电子版), 2023, 17(02): 89-93.
[10] 中华医学会外科学分会外科手术学学组, 中华医学会外科学分会移植学组, 华南劈离式肝移植联盟. 劈离式肝移植血管分割与重建中国专家共识[J]. 中华肝脏外科手术学电子杂志, 2023, 12(02): 167-172.
[11] 关明函, 薛志强. 右美托咪定改善大鼠脑缺血再灌注后脑损伤的研究[J]. 中华神经创伤外科电子杂志, 2023, 09(05): 270-276.
[12] 杨梦琦, 马慧芬, 訾阳, 王楠, 杜冰玉, 常万鹏, 于少泓. 马黛茶对脑血管疾病防治作用的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(04): 235-240.
[13] 张敏洁, 张小杉, 段莎莎, 施依璐, 赵捷, 白天昊, 王雅晳. 氢气治疗心肌缺血再灌注损伤的作用机制及展望[J]. 中华临床医师杂志(电子版), 2023, 17(06): 744-748.
[14] 张敏洁, 王雅晳, 段莎莎, 施依璐, 付文艳, 赵海玥, 张小杉. 基于GEO数据库和生物信息学分析筛选大鼠心肌缺血再灌注损伤相关潜在通路和靶点[J]. 中华临床医师杂志(电子版), 2023, 17(04): 438-445.
[15] 李宁, 刘言, 林慧庆. 肺移植供肺缺血再灌注损伤的机制及预防[J]. 中华胸部外科电子杂志, 2023, 10(04): 247-256.
阅读次数
全文


摘要