心脏移植供心保护研究进展
Research advances in donor heart preservation of heart transplantation
供心保护技术被应用于供心获取、转运乃至移植后的各个阶段。科学先进的供心保护方法对于扩大供心来源,改善心脏移植预后至关重要。静态冷保存(static cold storage,SCS)作为经典的供心保存技术,在短时供心转运条件下经济可靠,但随着保存时间增加,会造成严重的冷缺血损伤,并且无法及时监测和干预供心状态。近年来,一些新的供体心脏保存方法已经进入临床实践,包括静态控温系统、常温机械灌注系统和低温机械灌注系统。这些技术能有效扩大供心来源,延长供心转运时间,同时改善心脏移植远期预后。本文将结合华中科技大学同济医学院附属协和医院供心保护经验就供心保护技术的研究进展进行总结与探讨,为心脏移植供心保护提供理论依据。
更多The techniques of heart preservation are applied during various stages of heart procurement, transportation and transplantation. Scientific and advanced preservations of donor hearts are essential for expanding the source of hearts and improving the outcomes of heart transplantation. Static cold preservation (SCS), as a classic preservation technique, is both economical and reliable in short-term heart transportation conditions. However, with the elapsing of preservation time, it may cause serious cold ischemic injuries and cannot timely monitor and intervene the status of heart. In recent years, some new preservation methods of donor hearts have been applied in clinical practices, including static temperature control system, normothermic machine perfusion and hypothermic machine perfusion. These technologies can effectively expand the source of hearts, prolong the transportation time of hearts and optimize the long-term outcomes of heart transplantation. This review summarized the latest researches of heart preservation techniques based upon the experience of our own center, providing theoretical rationales for heart transplantation preservation.
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