诺姆热机器输液和炎症媒介吸附:第一个脏移植经验
Duilio Pagano1,2, Rosalia Busà3, Margot Lo Pinto4
1From the Department of Abdominal Center, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione) Palermo, Italy.
概括
使用常温机器输液与炎症介质去除成功地恢复了一个扩展标准的捐赠脏,防止移植后延迟的移植功能. 这种创新方法有望改善移植结果.
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
- 再生医学是一种再生医学.
背景情况:
- 由于器官短缺,需要使用扩展标准供体器官 (ECD) 来进行移植.
- 缺血-再输液损伤 (IRI) 是长期移植功能障碍的主要原因,特别是在ECD脏.
- 外置器官输液,包括常温机器输液 (NMP),为缓解IRI和评估器官活力提供了一个平台.
研究的目的:
- 评估将炎症媒介去除装置 (IMR) 整合到NMP中以恢复ECD脏的有效性.
- 评估IMR-NMP对器官活力标志物和炎症性细胞因子概况的影响.
- 为了确定使用IMR-NMP治疗的ECD的移植后结果.
主要方法:
- 一个ECD脏接受了320分钟的正常热机器输液 (NMP).
- 在 perfusion 过程中使用了一种综合炎症媒介去除 (IMR) 装置来吸附炎症分子.
- 通过尿液输出评估器官活力,并监测炎症性细胞因子水平.
- 评估了移植后的结果,包括延迟的移植功能 (DGF).
主要成果:
- 在NMP期间,IMR装置有效地以度依赖的方式去除了炎症性细胞因子.
- perfused ECD 脏表现出显著的尿液输出,表明保存了生命力.
- 移植的脏显示出成功的结果,没有任何延迟移植功能 (DGF) 的情况.
- perfusion 过程允许进行详细的器官活力评估和细胞因子调节.
结论:
- 将IMR设备与NMP集成是移植前恢复ECD脏的有希望的策略.
- 这种方法有效调节炎症反应,保持器官活力,减轻IRI.
- 成功的临床结果表明,在使用这种方法进行移植时,可以改善移植的存活率和功能.
- 需要进一步的研究来调查对移植存活的长期临床影响.
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