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肾脏离体机械灌注治疗新进展

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肾移植仍然是终末期肾病病人的金标准治疗方法.为了满足不断增长的器官需求,越来越多地使用心脏死亡捐献者(DCD)或扩大标准捐赠者(ECD)的器官.这些边缘器官发生严重缺血再灌注损伤的风险高,移植后原发性无功能、移植物功能延迟恢复和远期移植物存活率降低的发生率增加.肾脏离体机械灌注(EVMP)与传统静态冷保存相比,可以更好地保护供肾.EVMP还可以作为动态应用药物或基因治疗的平台,以进一步改善肾脏移植疗效.本综述概述了目前EVMP治疗的新策略,包括间充质干细胞疗法、基因疗法、纳米技术、抗感染剂、气体治疗、溶栓药、血型转化等.
New advances in ex vivo mechanical perfusion treatment for kidneys
Kidney transplantation remains the gold standard treatment for patients with end-stage renal disease.To address the growing demand for organs,there is an increasing reliance on organs from donors after cardiac death(DCD)and expanded criteria donors(ECD).These marginal organs are at a heightened risk of severe ischemia-reperfusion injury,which can lead to a higher incidence of primary nonfunction,delayed graft function,and reduced long-term graft survival rates following transplantation.Ex vivo machine perfusion(EVMP)provides superior protection for donor kidneys compared to traditional static cold storage.Additionally,EVMP can serve as a platform for the dynamic administration of drugs or gene therapies,further enhancing the efficacy of kidney transplantation.This review outlines innovative strategies for ex vivo kidney mechanical perfusion treatments,including mesenchymal stem cell therapy,gene therapy,nanotechnology,anti-infectives,gas therapy,thrombolytics,blood type conversion,and other therapeutic approaches.

kidney transplantationex vivo machine perfusionhypothermic mechanical perfusionnormothermic mechanical perfusion

林自国、王云昊、王彦峰

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430071 武汉大学中南医院,武汉大学肝胆疾病研究院,武汉大学移植医学中心,移植医学技术湖北省重点实验室

肾移植 离体机械灌注 低温机械灌注 常温机械灌注

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(11)