低温氧合机器灌注在扩展标准供体肝移植中的机制及优势  

Mechanism and advantages of hypothermic oxygenated machine perfusion in extended criteria donation liver transplantation

作　　者：秦茂玲(综述) 张华阳 成名翔[1] 涂兵(审校)[1] QIN Maoling;ZHANG Huayang;CHENG Mingxiang;TU Bing(Department of Hepatobiliary Surgery,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院肝胆外科,重庆400010

出　　处：《现代医药卫生》2024年第10期1752-1758,共7页Journal of Modern Medicine & Health

基　　金：重庆市自然科学基金项目(cstc2020jcyj-msxmX0791);重庆市科卫联合医学科研项目(2023MSXM020)。

摘　　要：近年来,由于肝移植供体的短缺问题日益突出,越来越多的机构开始采用扩展标准供体(ECD)的肝脏进行移植,然而,ECD肝脏移植术后并发症发生率较高且预后较差。低温氧合机器灌注(HOPE)作为一种肝移植供体的保存方式,被认为可改善移植患者预后,特别是对于ECD肝脏。HOPE的主要机制包括减轻线粒体损伤、氧化应激损伤、炎症及下调免疫应答。相较于其他灌注方式,HOPE可保护移植物的功能,延长肝脏的保存时间,并减少术后并发症。然而,尽管HOPE在临床上具有许多优势,但其应用仍处于探索阶段,且因其高昂的经济成本使其广泛开展受到限制,未来还需进一步的研究来充分体现和发挥HOPE的临床作用,使其更好地应用于临床。In recent years,due to the increasingly prominent shortage of liver transplant donors,more and more institutions have begun to use extended criteria donation(ECD)livers for transplantation.However,the incidence of postoperative complications and poor prognosis are higher for ECD liver transplantation.Hypothermic oxygenated machine perfusion(HOPE)is considered a method of preserving liver transplant donors that can improve the transplantation outcomes,especially for ECD livers.The main mechanisms of HOPE include reducing mitochondrial damage,oxidative stress damage,inflammation,and downregulating immune responses.Compared with other perfusion methods,HOPE can protect the function of the transplant,prolong the preservation time of the liver,and reduce postoperative complications.However,although HOPE has many advantages in clinical practice,its application is still in the exploratory stage,and its widespread use is limited by its high economic cost.Further research is needed in the future to fully demonstrate and realize the clinical role of HOPE,so that it can be better applied in clinical practice.

关 键 词：肝移植 低温氧合机器灌注 扩展标准供体 综述 

分 类 号：R617[医药卫生—外科学]