体外机械灌注在肝移植中的临床应用进展  

Progress in the clinical application of ex vivo machine perfusion in liver transplantation

作　　者：周瑞泉 谭海东[1] Zhou Ruiquan;Tan Haidong(Center of Liver Transplant(Second Department of Hepatopancreatobiliary Surgery),China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院肝脏移植中心(肝胆胰外科二部),北京100029

出　　处：《国际外科学杂志》2024年第4期217-222,共6页International Journal of Surgery

基　　金：中日友好医院高水平医院临床业务费专项临床研究项目(2023-NHLHCRF-LXYZ-01)

摘　　要：近年我国肝移植工作发展迅速,对供体器官的需求日益增长。面对器官短缺的困境,通过使用边缘性供体或扩大标准供体是解决短缺难题的现实方法之一。肝脏体外机械灌注相比于静态冷保存,能够实现对供体的活力评估和修复。在使用扩大标准供体时,机械灌注的优势得到广泛认可。机械灌注策略主要包括低温(氧合)机械灌注、常温机械灌注、控制性复温氧合灌注和无缺血肝移植,不同灌注策略具备其各自特点和优势。本文回顾总结了机械灌注技术的发展历程及各种机械灌注策略的特点,并展望其发展方向和应用前景,以期推动该技术的推广应用。In recent years,liver transplantation in China has developed rapidly,and the demand for donor organs is increasing.Faced with the dilemma of organ shortage,using marginal donors or expanding the criteria for standard donors is one of the practical methods to solve the problem.Compared with static cold storage,ex vivo machine perfusion in the liver transplantation can evaluate and repair the vitality of the grafts.The advantages of machine perfusion have been widely recognized when extended criteria donor organs were transplanted.Ex vivo mechanical perfusion strategies mainly include hypothermic(oxygenated)machine perfusion,normothermic machine perfusion,controlled oxygenated rewarming perfusion and ischemic-free liver transplantation,and different machine perfusion strategies have their own characteristics and advantages.This article reviews the development process and the characteristics of various machine perfusion strategies.The future development and application of machine perfusion were prospected in order to promote the widespread application of this technology.

关 键 词：肝移植 血液灌注 器官保存 无缺血肝移植 静态冷保存 

分 类 号：R657.3[医药卫生—外科学]