関連する実験動画
Updated: May 11, 2026
12:13
Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
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機械 の 輸血 の 後 の 肝臓 移植 は 危険 な 課題 と なっ て い ます
Riccardo Cirelli1, Adam M Thorne1, Otto B van Leeuwen1
1Department of Surgery, Division of HPB Surgery and Liver transplantation, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands.
Clinical transplantation
|September 1, 2025
まとめ
DHOPE-COR-NMPプロトコルによるex situ機械輸血は,重度のステアトーシスドナー肝臓を受給した2人の患者の合併症を予防できず,脂肪肝移植の課題を強調しました.
科学分野:
- ヘパトロジー
- 移植医学
- 臓器の保存
背景:
- ドナー肝臓の不足は,重度のステアトーシスを含む拡張基準の移植を必要とします.
- 重度のドナー肝臓ステアトーシスは,イシュケミア再注血による損傷に対する感受性を高め,移植の結果が悪くなる.
- 傷害を軽減し,高リスクの移植の生存可能性を評価する戦略です.
研究 の 目的:
- DHOPE-COR-NMPプロトコルの有効性を評価し,重度のステアトーシスのドナー肝臓のアウトカムを改善する.
- DHOPE-COR-NMPで保存された重度のステアトーシスドナー肝臓を受けた2人の患者の臨床結果について報告する.
主な方法:
- 低温酸素注入と正熱注入 (DHOPE-COR-NMPプロトコル) を組み合わせたex situ機械注入を使用した.
- 移植前に臨床的に検証された基準を用いて肝臓の活性を評価した.
- 輸血後の重度のステアトーシス症のドナー肝臓を投与した2人の患者の事例を紹介した.
主要な成果:
- 両方のステアトーシスドナー肝臓は,ノルモサーミック perfusion で良好に機能し,生存基準を満たした.
- 移植後に肺脂肪栓症候群を発症した患者もいます
- 2人目の受容者は 移植が失敗したため 再移植が必要で 病理学的には 大量の脂質の減少が見られました
結論:
- エックス・シットゥ・ペルフュージョンにもかかわらず,重度のステアトーシスのドナーの肝臓の移植は困難です.
- 脂肪栓塞や移植不全などのステアトーシスに関連した合併症は,生存能力の評価後でも発生することがあります.
- 肝臓移植におけるステアトーシス関連の合併症を予防するには,さらなる研究が不可欠です.
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