perfusate温度对已故捐赠者脏移植中延迟移植功能的影响
Ashley L Sweet1, Christopher R Connelly2, Elizabeth N Dewey1
1Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
概括
在低温机器输液 (HMP) 过程中,较高的早期输液温度与移植中移植功能的延迟有关. 保持温度低于10°C可能会降低这种风险.
科学领域:
- 科和移植手术 移植手术
- 器官保存和输液技术器官的保存和输液技术.
背景情况:
- 低温机器输液 (HMP) 与静态冷藏相比,降低了移植中的延迟移植功能 (DGF).
- 在HMP期间保持透液温度在410°C的目标范围内,对于最佳结果至关重要.
- 早期 perfusate 温度对 DGF 的影响需要进一步研究.
研究的目的:
- 为了确定在HMP.期间是否达到透的目标温度范围 (410°C).
- 为了研究更高的早期透温度和DGF的发病率之间的关联.
- 在接受HMP的脏全移植中识别DGF的预测因子.
主要方法:
- 追溯队列研究分析了来自已故捐赠者接受HMP的113个脏异位移植 (2019年6月~2020年8月).
- perfusate 温度在 perfusion 开始后的 5,15,60 和 180 分钟后被测量.
- 用单变量和多变量逻辑回归分析来确定DGF预测因素.
主要成果:
- 21%的分析过的移植 (n=21) 经历了延迟的移植功能.
- 较高的5分钟 perfusate 温度 (T5 分) 是 DGF 的一个显著的独立预测因子 (OR 1.58, P=.005).
- 与T5分钟>10°C的移植显示,与T5分钟<10°C (P=.006) 的移植相比,DGF的可能性增加了4.5倍.
结论:
- 在HMP期间提升的早期 perfusate 温度独立地与增加的DGF风险相关.
- perfusion 电路的冷却不足可能导致更高的早期 perfusate 温度.
- 实施质量改善措施以确保早期透温度≤10°C可能会降低DGF发病率.
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