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循环死亡后不受控制的捐赠肺移植计划:临床结果和实施前景

Alessandro Palleschi¹, Alberto Zanella², Marco Sacchi³

¹Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Milan, Italy.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

|February 24, 2026

概括

循环死亡后无控制捐献 (uDCD) 肺移植是可行的和有效的,提供与传统方法相比的结果. 通过实施简化标准热疗法策略和区域协调,可以显著增加用于肺移植的供体库.

科学领域:

移植免疫学移植免疫学
胸部外科手术胸部外科手术
器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐赠器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器官捐献器

背景情况:

肺移植 (LT) 由于供体器官稀缺而受到严重限制.
循环死亡后不受控制的捐赠 (uDCD) 提供了一个潜在的解决方案,但面临着后勤挑战.
现有的UDCD肺部利用策略往往复杂且未得到充分利用.

研究的目的:

评估循环死亡肺移植 (uDCD LT) 后不受控制的捐赠简化的标准热策略的可行性和结果.
评估UDCD LT.的单中心体验中的临床结果和器官利用率.
探索DCD肺部的区域捐助者潜力.

主要方法:

在单一中心 (2014-2025) 所有DCD肺转诊的前性评估.
使用开放式肺通风而没有现场冷却来保存肺部,然后进行ex vivo肺 perfusion (EVLP) 评估.
对临床结果和伦巴第地区捐赠者数据的分析.

主要成果:

在72名转诊捐赠者中,进行了18例肺移植,实现了EVLP后72%的利用率.
30天和1年的生存率分别为94.4%和83.3%.
主要移植功能障碍3级发生在16.7%的患者中,慢性肺部移植功能障碍发生在27.8%的患者中.

结论:

使用简化标准热策略的 uDCD LT 是可行的,安全和有效的.
这种方法的结果与传统的LT相美,并且在操作上具有可扩展性.
区域协调和更广泛的实施可以显著扩大肺捐赠者池.

关键词:

捐赠者池中的捐赠者池.肺部移植肺部移植预期的队列研究.在循环死亡后的不受控制的捐赠.

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