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Ex Situ Normothermic Machine Perfusion of Donor Livers
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在机器输血后移植严重的肝脏仍然是一个危险的挑战
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
概括
使用DHOPE-COR-NMP协议的现场机器输液并没有预防两名接受严重脂肪性供体肝脏的患者的并发症,这凸显了脂肪肝移植的挑战.
科学领域:
- 肝病学
- 移植医学
- 器官的保存
背景情况:
- 供体肝脏缺陷需要使用扩展标准移植,包括严重肥胖症患者.
- 严重的供体肝硬化增加了对缺血再输血损伤的敏感性,并导致移植结果不佳.
- 现场机器输液提供了一种潜在的策略来缓解损伤,并评估高风险移植的生存能力.
研究的目的:
- 评估DHOPE-COR-NMP协议在评估和改善严重肥胖性供体肝脏的疗效.
- 报告两名用DHOPE-COR-NMP保存的严重脂肪性供体肝脏患者的临床结果.
主要方法:
- 使用现场机器输液,结合低温氧化输液和正常热输液 (DHOPE-COR-NMP协议).
- 在移植之前使用临床验证的标准评估肝脏活力.
- 介绍了两名患者在输血后接受严重脂肪性供体肝脏的病例研究.
主要成果:
- 在正常热输液过程中,这两种肝脏都运作良好,符合生存标准.
- 一位接受者在移植后出现了肺脂肪栓塞综合征.
- 由于移植失败, 第二个接受者需要重新移植,
结论:
- 尽管进行了ex situ输血,但移植严重肥胖的供体肝脏仍然具有挑战性.
- 即使经过生命力评估,也可能出现与脂肪瘤相关的并发症,如脂肪栓塞和移植失败.
- 进一步的研究对于预防肝脏移植相关并发症至关重要.
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