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在循环死亡后捐赠的肝移植在体外膜氧化支持的捐赠者身上使用正常热区域输液

Andrew Jacques¹, Olivia Walker¹, Kara Monday¹

¹Department of Surgery, Baylor University Medical Center, Dallas, TX.

Transplantation direct

|October 27, 2025

概括

这项研究表明,在循环死亡 (DCD) 后使用常温区域 perfusion (NRP) 来进行外体膜氧化 (ECMO) 的捐赠者的肝移植是可行的. 这种技术为利用这些医学上复杂的DCD捐赠者提供了一个可行的选择.

科学领域:

移植医学移植医学
器官采购器官采购
支持心肺血管的支持.

背景情况:

常温区域输液 (NRP) 是一种在循环死亡 (DCD) 后进行捐赠的器官采购策略,可以改善肝移植结果.
医学上复杂的DCD捐赠者,特别是那些在体外膜氧化 (ECMO) 上的捐赠者,由于报告的经验有限,因此存在独特的挑战.
在DCD捐赠者中,ECMO的支持为增加捐赠者的可用性提供了一个潜在的途径,但需要专门的采购方法.

研究的目的:

用NRP技术描述ECMO支持的DCD捐赠者的肝移植的利用.
在一个小的案例系列中评估这种方法的技术和临床可行性.
突出在ECMO-DCD捐赠者中实施NRP的重要考虑因素.

主要方法:

对三例涉及腹部DCD-NRP.肝移植病例的回顾性分析.
在采购过程中,ECMO 管交换到 NRP 电路.
评估捐赠者的生理参数和接受者的结果.

主要成果:

捐赠者年龄超过50岁,热性缺血时间短 (<30分钟).
NRP持续时间在66到134分钟之间,在所有捐赠者中观察到乳酸清除.
接受者经历了短时间的ICU住院 (1天) 和长时间的住院 (5-7天),其中有一例是胆道静脉狭窄.

结论:

使用NRP的ECMO-DCD捐赠者的肝脏移植在技术和临床上是可行的.
精心进行管利用,电路配置和物流的术前计划对于成功实施NRP至关重要.
这种方法扩大了肝移植的潜在捐赠者群.

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