“机械灌注+”应用于扩大标准供肝移植—

工程（英文） ›› 2024, Vol. 32 ›› Issue (1) : 31 -44. DOI: 10.1016/j.eng.2023.11.003

研究论文

“机械灌注+”应用于扩大标准供肝移植——肝尽其用

王周城 ^a^,^b ,
Jack Martin ^c^,^d ,
余炯杰 ^a^,^b ,
汪恺 ^a^,^b^,^e ,
Kourosh Saeb-Parsy ^c^,^d ,
徐骁 ^a^,^b^,^e

作者信息 +

Machine Perfusion Plus for Extended Criteria Donor Liver Grafts: Making Every Liver Count

Zhoucheng Wang ^a^,^b^,^- ,
Jack Martin ^c^,^d^,^- ,
Jiongjie Yu ^a^,^b ,
Kai Wang ^a^,^b^,^e ,
Kourosh Saeb-Parsy ^c^,^d^,^* ,
Xiao Xu ^a^,^b^,^e^,^* ,

Author information +

文章历史 +

Received	Accepted	Published
2023-03-24	2023-11-13
Issue Date
2024-06-12

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摘要

移植是终末期肝病最有效的治疗方法，但由于供体器官的短缺而受到限制。扩大标准供体（ECD）供肝在临床实践中越来越多地用于缓解这一挑战。然而，这些移植物耐受缺血的能力下降，危及冷保存期间器官的活力。机器灌注（MP）旨在改善器官保存并减少移植后并发症。然而，越来越明显的是，单独使用MP无法达到ECD供肝的最佳保存状态。因此，人们逐渐开始重视改良的 MP 策略，包括使用不同的灌注剂、改良的灌注方式并结合不同的治疗干预策略。本文提出了“机械灌注+”的新理念，代表这些旨在提升器官功能并可能实现ECD供肝体外再生的机械灌注新策略。为此，本文总结了现有和改良的MP策略，并阐述其在临床场景中修复不同ECD供肝的优势。

Abstract

Transplantation represents the most effective treatment for end-stage liver diseases but is limited by the shortage of healthy donor organs. Extended criteria donor (ECD) liver grafts are increasingly utilized in clinical practice to mitigate this challenge. However, impaired ischemic tolerance of these grafts jeopardizes organ viability during cold storage. Machine perfusion (MP) was designed to improve organ preservation and reduce posttransplant complications. Nevertheless, it is increasingly evident that MP alone may not preserve ECD grafts optimally. Increasing emphasis has thus been placed on modified MP strategies, including the use of different perfusates, modified perfusion modalities, and different therapeutic interventions. Here, we introduce a novel term, “MP Plus,” denoting these additional strategies that are designed to restore organ function and potentially enable regeneration of ECD grafts. In this review, we summarize the existing and potential modified MP strategies and discuss their advantages in reconditioning different ECD grafts in clinical settings.