“机械灌注+”视阈下扩大标准供肝的修复与功能提升

Extended criteria donor reconditioning and functional improvement in the viewshed of machine perfusion plus

肝移植是终末期肝病最有效的治疗手段。我国是世界肝移植第二大国,为解决供肝短缺的瓶颈问题,扩大标准供肝的修复和功能提升是目前重要的研究方向。面向未来,基于医工信交叉融合创新平台,探求干细胞命运调控、器官修复与组织再生的基础理论突破,开展全国多中心、引领性的临床研究至关重要。由此,笔者综合国内外循证医学证据、最新研究成果及临床经验,基于“机械灌注+”的新理念,探索多组学技术、分子生物学技术、信息化技术、自动化技术、纳米靶向递送技术等与传统机械灌注技术相结合的新模式,以期实现实时、无创、智能化的供肝质量评估和检测,建立扩大标准供肝修复与功能提升的技术新体系,安全、有效地拓展供肝来源,降低移植后并发症风险,改善受者预后,从而推动我国肝移植事业更高质量发展。

Liver transplantation(LT)is one of the most effective treatments for end-stage liver diseases.The number of LT in China currently ranks as the second worldwide.Extended criteria donor(ECD)reconditioning and functional improvement is an important research direction at present in order to address the bottleneck of donor graft shortage.In the future,it is pivotal to explore the original breakthroughs in basic theories of stem cell fates regulation,organ restoration and tissue regeneration,and to conduct national-wide,multicenter clinical investigations on the basis of innovative platform of medical,engineering and information technology.Therefore,the authors summarize evidence-based medical proof,latest research achievements and clinical experi-ences with novel concept of"machine perfusion plus"to explore the most updated mode that inte-grates traditional machine perfusion with cutting edge technologies such as multi-omics,molecular biology,information technology,automation technology and nanoparticle targeted delivery tech-nology.This aims to achieve real-time,non-invasive,intelligent quality assessment and monitoring of donor graft,and finally to establish a new technology system of ECD reconditioning and functional improvement,which can safely and effectively expand the donor pool,decrease the risk of post-transplant complications,and improve the prognosis of recipients,thus promoting the higher quality development of LT in China.