CAJ | 학술논문

肝移植是目前治疗终末期肝病的唯一方法,但它受限于供肝的短缺.供肝的短缺扩大了其接受标准,其中包含了曾经因为不合适而丢弃的肝脏,即边缘肝脏.静态冷保存是目前器官保存的金标准.对于边缘肝脏,静态冷保存技术不能逆转这些器官的缺血损伤.在肝移植,冷保存的局限性表现为早期移植物功能障碍、原发无功和胆道局部缺血发生率显著升高,尤其是在老年供者、脂肪肝供者和心脏死亡供者(DCD)中更常见.现有冷保存技术已经限制了这类器官的使用,而机械灌注保存技术则成为另外一种选择.本文就机械灌注保存肝脏的研究进展做一综述,着重介绍常温机械灌注.
간이식시목전치료종말기간병적유일방법,단타수한우공간적단결.공간적단결확대료기접수표준,기중포함료증경인위불합괄이주기적간장,즉변연간장.정태랭보존시목전기관보존적금표준.대우변연간장,정태랭보존기술불능역전저사기관적결혈손상.재간이식,랭보존적국한성표현위조기이식물공능장애、원발무공화담도국부결혈발생솔현저승고,우기시재노년공자、지방간공자화심장사망공자(DCD)중경상견.현유랭보존기술이경한제료저류기관적사용,이궤계관주보존기술칙성위령외일충선택.본문취궤계관주보존간장적연구진전주일종술,착중개소상온궤계관주.
Liver transplantation is currently the only treatment option for end-stage liver disease,but it is limited by the lack of high quality donor livers.The ongoing liver donor shortage could be alleviated by the consequent expansion of do-nor criteria to include the use of livers that would once have been discarded as unsuitable,marginal livers.Static cold storage,the current gold standard of organ preservation,is incapable of reversing the ischemic damage these organs have sustained.In hepatic transplantation,the limitations of cold storage are reflected in the significantly higher rates of early al]ograft dysfunction,primary non-function,and local ischemic cholangiopathy,especially seen with older,steatotic and donation after cardiac death (DCD) grafts.The existing cold storage technology has restricted the use of this kind of organs and machine perfusion preservation technology becomes an alternative choice.In this paper,we review the research progress on machine perfusion preservation of livers,and introduce the normothermic machine perfusion.