Past, Present, and Future of Dynamic Kidney and Liver Preservation and Resuscitation

被引:92
作者
Jochmans, I. [1 ]
Akhtar, M. Z. [2 ,3 ]
Nasralla, D. [2 ,3 ]
Kocabayoglu, P. [4 ]
Boffa, C. [2 ,3 ]
Kaisar, M. [2 ,3 ]
Brat, A. [5 ]
O'Callaghan, J. [2 ,3 ,6 ,7 ]
Pengel, L. H. M. [2 ,3 ,6 ,7 ]
Knight, S. [2 ,3 ,6 ,7 ]
Ploeg, R. J. [2 ,3 ]
机构
[1] Katholieke Univ Leuven, Univ Hosp Leuven, Abdominal Transplant Surg, Leuven, Belgium
[2] Univ Oxford, Nuffield Dept Surg Sci, Biomed Res Ctr, Oxford, England
[3] Univ Oxford, Nuffield Dept Surg Sci, Oxford Transplant Ctr, Oxford, England
[4] Univ Hosp Essen, Dept Gen Visceral & Transplant Surg, Essen, Germany
[5] Univ Groningen, Univ Med Ctr Groningen, Dept Surg, Groningen, Netherlands
[6] Royal Coll Surgeons England, Ctr Evidence Transplantat, Clin Effectiveness Unit, London, England
[7] Univ Oxford, Oxford, England
关键词
clinical research; practice; organ procurement and allocation; liver transplantation; hepatology; kidney transplantation; nephrology; organ perfusion and preservation; clinical trial; HYPOTHERMIC MACHINE PERFUSION; STATIC COLD-STORAGE; VIVO NORMOTHERMIC PERFUSION; EXPANDED CRITERIA DONORS; CARDIAC DEATH; OXYGENATED PERFUSION; CIRCULATORY DEATH; GRAFT FUNCTION; REGIONAL PERFUSION; PORCINE KIDNEYS;
D O I
10.1111/ajt.13778
中图分类号
R61 [外科手术学];
学科分类号
摘要
The increased demand for organs has led to the increased usage of higher risk kidney and liver grafts. These grafts from donation after circulatory death or expanded criteria donors are more susceptible to preservation injury and have a higher risk of unfavorable outcomes. Dynamic, instead of static, preservation could allow for organ optimization, offering a platform for viability assessment, active organ repair and resuscitation. Ex situ machine perfusion and insitu regional perfusion in the donor are emerging as potential tools to preserve and resuscitate vulnerable grafts. Preclinical findings have ignited clinical organ preservation research that investigates dynamic preservation, its various modes (continuous, preimplantation) and temperatures (hypo-, sub, or normothermic). This review outlines the current status of dynamic preservation of kidney and liver grafts and describes ongoing research and emerging clinical trials. The authors summarize recent advances in the field of dynamic preservation of kidneys and livers, and detail ongoing and upcoming research that will advance the field.
引用
收藏
页码:2545 / 2555
页数:11
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