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摘要: 高质量的供器官对于移植成功至关重要,但随着肾衰竭患者的增多,标准供者已无法满足现阶段的移植需求,边缘供肾开始广泛应用于临床,这也对现有供肾保存方法提出了挑战。缺血-再灌注损伤(IRI)是影响肾移植术后早期移植物功能的重要因素之一,并且对移植物的长期存活产生有害影响。现有研究发现,血红蛋白类氧载体(HBOC)能够减轻肾移植过程中的IRI,有效改善供肾保存质量,延长供肾保存时间。本文综述了HBOC在肾移植中的研究进展,以期为改善供肾保存方法、提高供肾质量、改善受者预后提供参考。
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关键词:
- 肾移植 /
- 供肾保存 /
- 缺血-再灌注损伤(IRI) /
- 血红蛋白类氧载体(HBOC) /
- 低温机械灌注(HMP) /
- 控制性携氧复温(COR) /
- 全氟碳化合物(PFC) /
- 缺氧诱导因子(HIF)
Abstract: High-quality donor organs is of significance for the success of organ transplantation. However, standard donors fail to meet the requirements of kidney transplantation due to the increasing quantity of patients with kidney failure. Marginal donor kidneys have been widely applied in clinical practice, which also poses challenges to the existing preservation methods of donor kidneys. Ischemia-reperfusion injury (IRI) is one of the critical factors affecting the early graft function after kidney transplantation. In addition, it exerts harmful effect upon the long-term survival of the graft. Current studies have demonstrated that hemoglobin-based oxygen carrier (HBOC) may reduce the IRI during kidney transplantation, effectively improve the preservation quality and prolong the preservation time of donor kidney. In this article, the research progress on HBOC in kidney transplantation was reviewed, aiming to provide reference for modifying the preservation method of donor kidney, improve the quality of donor kidney and enhance clinical prognosis of the recipients. -
表 1 HBOC在器官保存中的应用的文献报道
Table 1. Literature reports on the application of HBOC in organ preservation
研究者 年份 HBOC种类 来源 器官种类 保存方式 研究进展 Matton, et al[38] 2018 HBOC-201 牛血 人肝脏 NMP 临床前研究 Aburawi, et al[12] 2019 HBOC-201 牛血 人肾脏 NMP 临床前研究 Bhattacharjee, et al[39] 2020 HBOC-201 牛血 猪肾脏 SNMP 临床前研究 Mahboub, et al[40] 2020 HBOC-201 牛血 大鼠肾脏 逐渐复温灌注 临床前研究 Shonaka, et al[20] 2018 HbV① 人血 猪肝脏 SNMP 临床前研究(起步阶段) Thuillier, et al[41] 2011 M101 海洋无脊椎动物 猪肾脏 冷保存 临床前研究 Mallet, et al[42] 2014 M101 海洋无脊椎动物 猪肾脏 冷保存 临床前研究 Yannick, et al② 2016 M101 海洋无脊椎动物 人肾脏 机械灌注 临床研究(NCT02652520,已完成) Teh, et al[43] 2017 M101 海洋无脊椎动物 大鼠心脏 冷保存 临床前研究 Glorion, et al[44] 2018 M101 海洋无脊椎动物 猪肺脏 冷保存 临床前研究 Kasil, et al[45] 2019 M101 海洋无脊椎动物 猪肾脏 机械灌注 临床前研究 Kaminski, et al[46] 2019 M101 海洋无脊椎动物 猪肾脏 冷保存、机械灌注 临床前研究 Yannick, et al② 2020 M101 海洋无脊椎动物 人肾脏 -③ 临床研究(NCT04181710,研究中) Fontes, et al[47] 2015 HemopureTM 牛血 猪肝脏 SNMP 临床前研究(起步阶段) 注:①HbV为血红蛋白胶囊。
②研究中尚未发表。
③-为无数据。 -
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