携氧技术在肝移植供肝保存中的应用  

The application of oxygen carriers technology in donor liver protection

作　　者：贾俊君[1] 李建辉[1,2] 张静[1] 周燕飞[1] 周琳[1] 郑树森[1,2] 

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）》2015年第3期145-149,共5页Chinese Journal of Transplantation(Electronic Edition)

基　　金：国家科技重大专项(2012ZX10002-017);国家自然科学基金创新群体(81121002);国家自然科学基金面上项目(81000137;81470891);浙江钱江人才计划(2012R10045);国家高技术发展研究计划863青年科学家计划(2015AA020923)

摘　　要：供肝短缺问题是制约肝移植发展的主要因素,供肝保存技术是保证并进一步扩展供肝来源的关键。供肝保存过程中携氧技术的应用有望进一步提高心脏死亡器官捐献(DCD)和扩大标准器官捐献(ECD)供肝质量。本文综述了携氧载体、携氧方式及相关应用机制等方面最新进展。医用携氧载体主要包括血红蛋白类物质及全氟化碳类物质(PFC)。携氧方式包括吹入法、鼓泡式氧合及膜式氧合3种。携氧技术提高供肝质量的机制主要是抑制过多氧自由基产生、减少缺血再灌注损伤。随着DCD及ECD供肝越来越多进入临床,携氧技术必将得到越来越广泛的应用,且PFC为缓解血制品供不应求提供了新的解决途径。Shortage of donor liver is a major factor restricting the development of liver transplantation,and liver preservation technology is the key to guarantee and further expanding sources of donor liver. Oxygen carriers technology is an ideal technology to further improve graft quality of donation after cardiac death（ DCD） and expand criteria donor（ ECD）. This review covers the latest issues of oxygen carriers, methods of oxygenation and related application. The hemoglobin and perfluorocarbon（ PFC） are the most commonly used oxygen carriers. There are three different kinds of oxygenation as insufflations,bubbling oxygenation and membrane oxygenation. The mechanism of this technology to protect ECD is mainly due to inhibition excessive oxygen free radicals which further reduces ischemia reperfusion injury. With more and more DCD or ECD were used in clinical,the oxygen carriers technology will be more and more carried out. Further,PFC provides a new solution to alleviate the short supply of blood product.

关 键 词：肝移植 携氧技术 供肝保存 

分 类 号：R657.3[医药卫生—外科学]