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Updated: Aug 2, 2026
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Ex Situ Normothermic Machine Perfusion of Donor Livers
Published on: May 26, 2015
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持续的脏替代疗法在长期的正常热机器 perfusion 的人类捐赠者的肝脏多达7 D期间
Bianca Lascaris1,2, Roland F Hoffmann3, Maarten W N Nijsten4
1Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Transplantation direct
|January 26, 2024
概括
连续置换疗法 (CRRT) 与正常热机器输液 (NMP) 结合,可稳定供体肝 perfusate 组成长达 7 天. 这种设置还可以通过超过剂监测葡萄糖和乳酸等小分子,确保器官的活力.
科学领域:
- 移植免疫学 移植免疫学
- 器官保存技术 器官保存技术
- 生物医学工程 生物医学工程
背景情况:
- 常温机器输液 (NMP) 保存了供体肝脏,但导致了输液废物积累.
- 在NMP期间的代谢活动需要有效的废物清除和监测.
- 目前的NMP协议在长时间内保持最佳的输液平衡方面面临着挑战.
研究的目的:
- 描述一个简化,成本效益的设置,将连续脏置换疗法 (CRRT) 与NMP整合起来.
- 评估CRRT在延长NMP (长达7天) 期间维持透性平衡的疗效.
- 评估CRRT超的效用,用于监测输液中的关键小分子度.
主要方法:
- 在56个没有CRRT的人类NMP程序中分析透物成分.
- 整合一个0.2平方米的透析过器到6个丢弃的人体捐赠肝脏中CRRT的NMP电路中.
- 连续超和液体替代被应用长达7天.
主要成果:
- 在没有CRRT的情况下,NMP透酸呈现出透性,尿素和酸盐的快速增加,达到超生理水平.
- 在12小时内,CRRT整合使 perfusate 组成正常化,达到生理学值.
- 在使用CRRT的7天NMP期间,均质维持在CRRT.
- 超过葡萄糖和乳酸盐水平与透酸盐水平有很强的相关性 (分别r=0.997和r=0.999).
结论:
- 在延长的NMP期间,CRRT有效地纠正和维持生理透成分.
- 超过的CRRT提供了一种可靠的方法来监测小分子度.
- 这种综合方法可以提高捐赠肝脏的保存和评估,而不会损害无菌性.
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