{"id":3854,"date":"2023-07-12T13:40:37","date_gmt":"2023-07-12T05:40:37","guid":{"rendered":"https:\/\/transnovo.com\/news\/%e4%b8%93%e5%ae%b6%e8%ae%ba%e5%9d%9b-%e6%89%a9%e5%a4%a7%e6%a0%87%e5%87%86%e4%be%9b%e8%82%9d%e4%b8%b4%e5%ba%8a%e5%ba%94%e7%94%a8%e7%a0%94%e7%a9%b6%e4%b8%8e%e8%bf%9b%e5%b1%95\/"},"modified":"2023-07-12T13:40:37","modified_gmt":"2023-07-12T05:40:37","slug":"%e4%b8%93%e5%ae%b6%e8%ae%ba%e5%9d%9b-%e6%89%a9%e5%a4%a7%e6%a0%87%e5%87%86%e4%be%9b%e8%82%9d%e4%b8%b4%e5%ba%8a%e5%ba%94%e7%94%a8%e7%a0%94%e7%a9%b6%e4%b8%8e%e8%bf%9b%e5%b1%95","status":"publish","type":"post","link":"https:\/\/transnovo.com\/en\/news\/%e4%b8%93%e5%ae%b6%e8%ae%ba%e5%9d%9b-%e6%89%a9%e5%a4%a7%e6%a0%87%e5%87%86%e4%be%9b%e8%82%9d%e4%b8%b4%e5%ba%8a%e5%ba%94%e7%94%a8%e7%a0%94%e7%a9%b6%e4%b8%8e%e8%bf%9b%e5%b1%95\/","title":{"rendered":"Expert Forum | Research and Progress on Expanding the Clinical Application of Standardized Liver Supplies"},"content":{"rendered":"
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ECD\u4f9b\u809d\u6307\u4e0d\u7b26\u5408\u7406\u60f3\u4f9b\u809d\u9009\u62e9\u6807\u51c6\uff0c\u4f46\u4f9d\u7136\u53ef\u4ee5\u7528\u4e8e\u79fb\u690d\u7684\u809d\u810f\u3002<\/span><\/strong>\u6807\u51c6\u4f9b\u809d\u6216\u7406\u60f3\u4f9b\u809d\u6ca1\u6709\u786e\u5207\u5b9a\u4e49\uff0c\u8fc7\u53bb\u8ba4\u4e3a\u5e94\u5177\u5907\u4ee5\u4e0b\u6761\u4ef6\uff1a\u4f9b\u4f53\u5e74\u9f84\u5c0f\u4e8e40\u5c81\uff0c\u6b7b\u4ea1\u539f\u56e0\u4e3a\u9885\u8111\u521b\u4f24\uff0c\u8111\u6b7b\u4ea1\u6350\u732e\uff0c\u5668\u5b98\u83b7\u53d6\u524d\u4f9b\u4f53\u8840\u6d41\u52a8\u529b\u5b66\u7a33\u5b9a\uff0c\u6ca1\u6709\u8102\u80aa\u809d\u6216\u5176\u4ed6\u6f5c\u5728\u6162\u6027\u809d\u810f\u75c5\u53d8\uff0c\u4e0d\u5408\u5e76\u4f20\u67d3\u6027\u75be\u75c5\u7b49[1,2]<\/sup>.<\/p>\n


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\u76f8\u5bf9\u4e8e\u4e0a\u8ff0\u6761\u4ef6\uff0cECD\u4f9b\u809d\u591a\u8ba4\u4e3a\u5177\u5907\u4ee5\u4e0b\u7279\u70b9[3]<\/sup>\uff1a\u9ad8\u9f84\u4f9b\u809d\uff08\u226565\u5c81\uff09\uff0c\u5927\u6ce1\u6027\u8102\u80aa\u809d\uff08\u226530%\uff09\uff0c\u5fc3\u6b7b\u4ea1\uff08Donation after cardiac death, DCD\uff09\u4f9b\u809d\uff0c\u4f9b\u4f53ICU\u505c\u7559\u65f6\u95f4\u8d85\u8fc77\u5929\uff0c\u5408\u5e76\u9ad8\u94a0\u8840\u75c7\uff08\u2265165mmol\/L\uff09\uff0c\u8840\u6e05\u603b\u80c6\u7ea2\u7d20\u8d85\u8fc7\u6b63\u5e38\u503c\u4e0a\u96503\u500d\uff0c\u5929\u51ac\u6c28\u9178\u8f6c\u6c28\u9176\/\u4e19\u6c28\u9178\u8f6c\u6c28\u9176\u660e\u663e\u5347\u9ad8\uff0c\u8c37\u6c28\u9170\u8f6c\u80bd\u9176\u2265200\u5355\u4f4d\uff0c\u4f9b\u809d\u51b7\u4fdd\u5b58\u65f6\u95f4\u8fc7\u957f\uff08\u226512h\uff09\uff0c\u4f9b\u4f53\u6b7b\u4ea1\u539f\u56e0\u4e3a\u8111\u8840\u7ba1\u610f\u5916\u4e14\u5408\u5e76\u7cd6\u5c3f\u75c5\u548c\u9ad8\u8840\u538b\u75c5\uff0c\u4f9b\u809d\u83b7\u53d6\u524d\u4f9b\u4f53\u4f7f\u7528\u4e86\u5927\u5242\u91cf\u6216\u4e24\u79cd\u4ee5\u4e0a\u8840\u7ba1\u6d3b\u6027\u836f\uff0c\u6b64\u5916\uff0c\u8fd8\u5305\u62ec\u5408\u5e76\u809d\u708e\u75c5\u6bd2\u611f\u67d3\u7684\u4f9b\u809d\u548c\u5288\u79bb\u5f0f\u4f9b\u809d\u7b49\u3002<\/p>\n


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DCD\u4f9b\u809d\u53ef\u80fd\u589e\u52a0\u79fb\u690d\u98ce\u9669\u3002<\/span><\/strong>\u7136\u800c\u7b26\u5408\u4ee5\u4e0b\u6761\u4ef6\u7684\u53ef\u63a7\u578bDCD\u4f9b\u809d\u53ef\u4ee5\u5b89\u5168\u5730\u7528\u4e8e\u4e34\u5e8a\uff1a\u4f9b\u4f53\u5e74\u9f84<40\u5c81\uff0cICU\u65f6\u95f4<5\u5929\uff0c\u529f\u80fd\u6027\u70ed\u7f3a\u8840\u65f6\u95f4<15min\uff0c\u51b7\u4fdd\u5b58\u65f6\u95f4<8h\uff0c\u6ca1\u6709\u8102\u80aa\u53d8\u6027\u3002\u65b0\u8fd1\u7684\u7814\u7a76\u53c8\u63d0\u51fa\u4e86ECD-DCD\u4f9b\u809d\u6982\u5ff5[7]<\/sup>\uff0c\u5373\u4f9b\u4f53\u5e74\u9f84>50\u5c81\uff0cBMI>35kg\/m2\uff0c\u529f\u80fd\u6027\u70ed\u7f3a\u8840\u65f6\u95f4>30min\uff0c\u5927\u6ce1\u6027\u8102\u80aa\u53d8\u6027>30%\uff0c\u7b26\u5408\u5176\u4e2d1\u9879\u5373\u4e3aECD-DCD\u3002\u7814\u7a76\u8ba4\u4e3a\u79d1\u5b66\u9009\u62e9\u53d7\u8005\uff0c\u4f18\u5316\u56f4\u624b\u672f\u671f\u5904\u7406\u65b9\u6848\uff0c\u53ef\u4ee5\u63d0\u9ad8ECD-DCD\u4f9b\u809d\u5229\u7528\u7387\uff0852%\uff09\uff0c\u6539\u5584\u79fb\u690d\u7269\u9884\u540e\uff081\u5e7493%\uff09\uff0c\u964d\u4f4e\u7f3a\u8840\u6027\u80c6\u75c5\u5e76\u53d1\u75c7\uff085%\uff09[7]<\/sup>.<\/p>\n


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NRP\u663e\u8457\u6539\u5584\u4e86ECD-DCD\u4f9b\u809d\u8d28\u91cf\uff0c\u540c\u65f6\uff0c\u589e\u52a0\u4e86\u4f9b\u4f53\u5668\u5b98\u83b7\u53d6\u524d\u529f\u80fd\u8bc4\u4f30\u7684\u53ef\u80fd\u6027\uff0c\u6781\u5927\u5730\u63d0\u9ad8ECD-DCD\u4f9b\u809d\u5229\u7528\u7387\u3002NRP\u5c24\u5176\u5bf9\u4e0d\u53ef\u63a7\u5fc3\u6b7b\u4ea1\u4f9b\u4f53\uff08uDCD\uff09\u5668\u5b98\u4fdd\u62a4\u6709\u7740\u975e\u5e38\u91cd\u8981\u7684\u610f\u4e49<\/span><\/strong>[8]<\/sup>.<\/p>\n


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MP\u53ef\u5206\u4e3a\u5e38\u6e29\u548c\u4f4e\u6e29\u673a\u68b0\u704c\u6ce8\u3002\u5e38\u6e29\u673a\u68b0\u704c\u6ce8\uff08NMP\uff09\u53ef\u4ee5\u663e\u8457\u5ef6\u957f\u4f9b\u809d\u4fdd\u5b58\u65f6\u9650\uff0c\u964d\u4f4e\u4f9b\u809d\u5f03\u7528\u7387\uff0c\u51cf\u8f7b\u4f9b\u809d\u7684\u635f\u4f24\uff0c\u5e76\u4e14\u53ef\u4ee5\u79d1\u5b66\u5224\u65ad\u4f9b\u809d\u7684\u53ef\u7528\u6027[9,10]<\/sup>\u3002NMP\u8bc4\u4ef7\u4f9b\u809d\u53ef\u7528\u6027\u6807\u51c6\u5305\u62ec\uff1a\u80c6\u6c41pH>7.5\uff0c\u80c6\u6c41\u8461\u8404\u7cd6\u6d53\u5ea6\u22643mmol\/L\u6216\u4f4e\u4e8e\u704c\u6ce8\u6db2\u8461\u8404\u7cd6\u6c34\u5e73\u81f3\u5c1110mmol\/L, \u7ef4\u6301\u704c\u6ce8\u6db2pH>7.2\uff0c\u78b3\u9178\u6c22\u76d0\u8865\u5145\u4e0d\u8d85\u8fc730mmol, \u8461\u8404\u7cd6\u6301\u7eed\u51cf\u5c11\u8d85\u8fc72h\u6216\u8461\u8404\u7cd610mmol\/L\u4ee5\u4e0b\uff0c\u4e73\u9178\u5cf0\u503c\u4e0b\u964d\u22654.4mmol\/L\/kg\/h\uff0c\u704c\u6ce82h\u4e19\u6c28\u9178\u6c28\u57fa\u8f6c\u79fb\u9176<6000U\/L\u3002\u6216\u704c\u6ce8\u6db2\u4e73\u9178\u6c34\u5e73\u4f4e\u4e8e2.5mmol\/L\uff0c\u80c6\u6c41\u4ea7\u751f\u6ee1\u610f\uff0c\u704c\u6ce8\u6db2pH>7.30\uff0c\u809d\u52a8\u8109\u6d41\u91cf>150ml\/min, \u95e8\u9759\u8109\u6d41\u91cf>500ml\/min[11,12]<\/sup>.<\/p>\n


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\u968f\u7740NRP\u548cMP\u6280\u672f\u4e0d\u65ad\u6210\u719f\uff0c\u6b27\u7f8e\u56fd\u5bb6\u4f7f\u7528NRP\u548cMP\u4fdd\u5b58\u540e\u518d\u884c\u809d\u79fb\u690d\u7684\u4e2d\u5fc3\u65e5\u8d8b\u589e\u591a\u3002\u65b0\u8fd1\u7814\u7a76\u62a5\u544a\uff0c\u51e0\u4e4e\u5168\u7f8e\u5404OPO\u90fd\u4f7f\u7528\u4e86NRP\u548cMP\u6280\u672f\uff0c2016\u5e741\u6708\u81f32021\u5e746\u6708\uff0c\u7f8e\u56fd\u5171\u6709374\u4f8bECD-DCD\u4f9b\u809d\u7ecf\u8fc7\u673a\u68b0\u704c\u6ce8\u540e\u7528\u4e8e\u809d\u79fb\u690d\uff0c\u79fb\u690d\u672f\u540e 1\u5e74\u30012\u5e74\u548c3\u5e74\u7684\u79fb\u690d\u7269\u5b58\u6d3b\u7387\u5206\u522b\u4e3a90.1%\u300189.1%\u548c87.0%[15]<\/sup>\u30022015\u5e74\u81f32020\u5e74\uff0c\u610f\u5927\u5229\u5229\u7528NRP\u8054\u5408MP\u6280\u672f\uff0c\u4f7f\u5f97DCD\u4f9b\u809d\u5229\u7528\u7387\u63d0\u9ad8\u5230\u4e8669.2%\uff0c\u53d6\u5f97\u4e86\u6ee1\u610f\u7597\u6548[16]<\/sup>.<\/p>\n


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Reference:<\/span><\/p>\n

1.      Feng S, Goodrich NP, Bragg-Gresham JL, et al. Characteristics associated with liver graft failure: the concept of a donor risk index. Am J Transplant 2006;6(4):783-790.<\/span><\/p>\n

2.      New York State Department of Health Workgroup. Workgroup on expanded criteria organs for liver transplantation. Liver Transpl 2005;11(10):1184-1192.<\/span><\/p>\n

3.      Fran\u00e7ois Durand, John F Renz, Barbara AlkoferLiver, et al. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation<\/span><\/p>\n

Transpl. 2008;14(12):1694-707.<\/span><\/p>\n

4.      K.J. Halazun, A.A. Rana, B. Fortune, et al. No country for old livers? Examining and optimizing the utilization of elderly liver grafts.  Am J Transplant. 2018;18 (3): 669\u2013678.<\/span><\/p>\n

5.      P. Domagala, K. Takagi, J.N. Ijzermans, et al. Grafts from selected deceased donors over 80 years old can safely expand the number of liver transplants: a systematic review and meta-analysis. Transplant. 2019; 33 (4) : 209\u2013218.<\/span><\/p>\n

6.      P.A. Cascales-Campos, P. Ram\u00edrez, M.R. Gonz\u00e1lez-S\u00e1nchez, et al. Orthotopic liver transplantation with elderly donors (over 80 Years of age): a prospective evaluation, Transplant. Proc. 2018; 50 (10):3594\u20133600.<\/span><\/p>\n

7.      Plamen Mihaylov, Richard Mangus, Burcin Ekser, et al. Expanding the Donor Pool With the Use of Extended Criteria Donation After Circulatory Death Livers. Liver Transpl. 2019;25(8):1198-1208.<\/span><\/p>\n

8.      Amelia J Hessheimer , Mikel Gastaca , Eduardo Mi\u00f1ambres , et al. Donation after circulatory death liver transplantation: consensus statements from the Spanish Liver Transplantation Society. Transpl Int 2020;33(8):902-916.<\/span><\/p>\n

9.      David Nasralla , Constantin C Coussios, Hynek Mergental, et al.  A randomized trial of normothermic preservation in liver transplantation Nature 2018;557(7703):50-56.<\/span><\/p>\n

10.  Pierre-Alain Clavien, Philipp Dutkowski, Matteo Mueller, et al. Transplantation of a human liver following 3 days of ex situ normothermic preservation. Nat Biotechnol 2022 ;40(11):1610-1616.<\/span><\/p>\n

11.  Yuri L Boteon, Richard W Laing, Andrea Schlegel, et al. Combined Hypo-thermic and Normothermic Machine Perfusion Improves Functional Reco-very of Extended Criteria Donor Livers. Liver Transp 2018;24(12):1699-1715<\/span><\/p>\n

12.  Annemarie Weissenbacher, Georgios Vrakas, David Nasralla, et al.The future of organ perfusion and re-conditioning. Transplant International 2019; 32(6): 586\u2013597.<\/span><\/p>\n

13.  Rianne van Rijn, Ivo J Schurink , Yvonne de Vries, et al. Hypothermic Machine Perfusion in Liver Transplantation – A Randomized Trial N Engl J Med 2021;384(15):1391-1401.<\/span><\/p>\n

14.  Yili Zhang, Yangmin Zhang, Mei Zhang, et al. Hypothermic machine perfusion reduces the incidences of early allograft dysfunction and biliary complications and improves 1-year graft survival after human liver transplantation: A meta-analysis. Medicine (Baltimore) 2019 Jun;98(23):e16033.<\/span><\/p>\n

15.  Kristopher P. Croome. The Current Landscape of Liver Transplantation After Ex Situ Machine Perfusion and Normothermic Regional Perfusion in the United States. Liver Transpl.  2022;28(6):1108-1112. <\/span><\/p>\n

16.  Riccardo De Carlis, Andrea Lauterio, Leonardo Centonze, et al. Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy. Updates Surg 2022;74(2):501-510.<\/span><\/p>\n


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Scan the code to follow us<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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Micro Signal\uff5cTx New Solution<\/p>\n

Jianfeng Medicine, focus on transplant industry<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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