Thoraco-abdominal normothermic regional perfusion for thoracic transplantation in the United States: current state and future directions.

IF 1.8 4区医学 Q3 TRANSPLANTATION

Current Opinion in Organ Transplantation Pub Date : 2024-06-01 Epub Date: 2024-03-14 DOI:10.1097/MOT.0000000000001143

Swaroop Bommareddi, Brian Lima, Ashish S Shah, John M Trahanas

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引用次数: 0

Abstract

Purpose of review: To provide an update regarding the state of thoracoabdominal normothermic regional perfusion (taNRP) when used for thoracic organ recovery.

Recent findings: taNRP is growing in its utilization for thoracic organ recovery from donation after circulatory death donors, partly because of its cost effectiveness. taNRP has been shown to yield cardiac allograft recipient outcomes similar to those of brain-dead donors. Regarding the use of taNRP to recover donor lungs, United Network for Organ Sharing (UNOS) analysis shows that taNRP recovered lungs are noninferior, and taNRP has been used to consistently recover excellent lungs at high volume centers. Despite its growth, ethical debate regarding taNRP continues, though clinical data now supports the notion that there is no meaningful brain perfusion after clamping the aortic arch vessels.

Summary: taNRP is an excellent method for recovering both heart and lungs from donation after circulatory death donors and yields satisfactory recipient outcomes in a cost-effective manner. taNRP is now endorsed by the American Society of Transplant Surgeons, though ethical debate continues.

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美国用于胸腔移植的胸腹腔常温区域灌注：现状与未来方向。

综述目的：最近的研究结果：taNRP越来越多地被用于循环死亡后捐献者胸部器官的恢复，部分原因是其成本效益。taNRP已被证明可产生与脑死亡捐献者相似的心脏异体移植受体结果。关于使用 taNRP 恢复捐献者肺脏的问题，器官共享联合网络（UNOS）的分析表明，taNRP 恢复的肺脏效果并不差，而且高容量中心使用 taNRP 恢复的肺脏一直很好。小结：taNRP 是一种从循环死亡后捐献的供体中恢复心脏和肺的极佳方法，并能以经济有效的方式获得令人满意的受体结果，目前已获得美国器官移植外科医生协会的认可，但伦理争议仍在继续。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.