肝移植供肝保存新途径:机械灌注  

The new donor liver preservation method: machine perfusion

作　　者：贾俊君[1] 李建辉[2] 姜骊[1] 周琳[1] 郑树森[2] 

机构地区：[1]浙江大学医学院附属第一医院 卫生部多器官联合移植重点实验室,杭州310003 [2]浙江大学医学院附属第一医院肝胆胰外科,杭州310003

出　　处：《中华移植杂志（电子版）》2014年第3期44-48,共5页Chinese Journal of Transplantation(Electronic Edition)

基　　金：国家科技重大专项(2012ZX10002-017)

摘　　要：肝移植是治疗终末期肝病最有效的方法,但由于供肝短缺形势严峻,进一步发展并完善新的离体肝脏保存技术成为必然。机械灌注(MP)是一种新型的供肝保存方法,与传统的静态冷保存相比,能更好地保存离体肝脏,甚至可以挽救非标准供肝,从而进一步扩大供肝池。根据温度不同,MP可以分为低温、亚低温以及常温3种类型。目前针对肝移植的MP尚处于临床试验阶段,其主要技术参数仍需要进一步探索验证。总之,MP为解决供肝短缺提供了新思路,为了获得临床应用仍需要进一步研究,使其简化并合理优化灌注参数。Liver transplantation is the only cure for end-stage liver diseases, but nowadays the donor shortage becomes the critical problem which triggers to explore new preservation method. Machine perfusion （MP） is a new-developed donor liver preservation method, compared to the static cold storage, MP can resuscitate for extended criteria donors which further expanded donor pool. According to temperature, MP can be divided into hypothermic, subnomothermic and normothermie MP, but so far only one clinical study of MP was reported and there were no consensus on the optimal solution or MP settings including optimal pressures, flows velocity, double or single vessel perfusion, with or without oxygen. In conclusion, MP technologies have been explored to challenge the limitations of the current static cold storage. To facilitate the translation of MP to clinical application, more simplified technique is prerequisite and optimization of perfusion parameters such as temperature, flow rate, perfusion media and the ideal oxygen carrier should be determined in future study.

关 键 词：肝移植 机械灌注 供肝保存 

分 类 号：R657.3[医药卫生—外科学]