Donor-derived infections among Chinese donation after cardiac death liver recipients

AIM To investigate blood cultures of deceased donors and report the confirmed transmission of bacterial infection from donors to liver recipients.METHODS We retrospectively studied the results of blood cultures among our donation after cardiac death(DCD) donors and calculated the donor-derived bacterial infection rates among liver recipients. Study participants underwent liver transplantation between January 1, 2010 and February 1, 2017. The study involved a total of 67 recipients of liver grafts from 67 DCD donors. We extracted the data of donors' and patients' characteristics, culture results and clinical outcomes, especially the post-transplant complications in liver recipients, from electronic medical records. We analyzed the characteristics of the donors and the corresponding liver recipients with emphasis put on donor-derived infections.RESULTS Head trauma was the most common origin of death among our 67 DCD donors(46.3%). Blood taken prior to the procurement operation was cultured for 53 of the donors, with 17 episodes of bloodstream infections developing from 13 donors. The predominant organism isolated from the blood of donors was Gram-positive bacteria(70.6%). Only three(4.5%) of 67 liver recipients developed confirmed donor-derived bacterial infections,with two isolates of multidrug-resistant Klebsiella pneumoniae and one isolate of multidrug-resistant Enterobacter aerogenes. The liver recipients with donorderived infections showed relation to higher crude mortality and graft loss rates(33.3% each) within 3 mo post transplantation, as compared to those without donor-derived infections(9.4% and 4.7%, respectively). All three liver recipients received appropriate antimicrobial therapy.CONCLUSION Liver recipients have high occurrence of donor-derived infections. The liver recipients with donor-derived multidrug-resistant Enterobacteriaceae infections can have good outcome if appropriate antimicrobial therapy is given.

Current situation of mechanical CPR devices in donors after cardiac death

Mechanical CPR (cardiopulmonary resuscitation) devices help performing correct chest compressions in the event of a cardiorespiratory arrest. These devices are comfortable and useful, they keep chest compression following the recommendations as they do not depend on interpersonal variability, they do not get tired, their use is simple and one of the rescuers is released from this task, thus facilitating the assistance. Besides, their use in transport conditions makes it safer. However, when coming to results, these mechanical CPR devices have not clearly demonstrated such an advantage, neither in the field of cardiac arrest, nor in organ preservation in the case of donors after cardiac death. In donors after cardiac death they are widely used by most of the emergency services involved, but a number of injuries produced in lungs during the early years of their use have made it controversial. In this paper we make a review of the road traveled by mechanical CPR devices and of the main articles which mark the way.

Developing a donation after cardiac death risk index for adult and pediatric liver transplantation

AIM To identify objective predictive factors for donor after cardiac death(DCD) graft loss and using those factors, develop a donor recipient stratification risk predictive model that could be used to calculate a DCD risk index(DCD-RI) to help in prospective decision making on organ use.METHODS The model included objective data from a single institute DCD database(2005-2013, n = 261). Univariate survival analysis was followed by adjusted Cox-regressional hazard model. Covariates selected via univariate regression were added to the model via forward selection, significance level P = 0.3. The warm ischemic threshold was clinically set at 30 min. Points were given to each predictor in proportion to their hazard ratio. Using this model, the DCD-RI was calculated. The cohort was stratified to predict graft loss risk and respective graft survival calculated.RESULTS DCD graft survival predictors were primary indication for transplant(P = 0.066), retransplantation(P = 0.176), MELD > 25(P = 0.05), cold ischemia > 10 h(P = 0.292) and donor hepatectomy time > 60 min(P = 0.028).According to the calculated DCD-RI score three risk classes could be defined of low(DCD-RI < 1), standard(DCD-RI 2-4) and high risk(DCD-RI > 5) with a 5 years graft survival of 86%, 78% and 34%, respectively.CONCLUSION The DCD-RI score independently predicted graft loss(P < 0.001) and the DCD-RI class predicted graft survival(P < 0.001).

Kidney donation after cardiac death

There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death(DCD) and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to controlled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function(DGF) and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that significantly influences the outcome of allografts, for example, limiting it to < 12 h markedly reduces DGF. DCD kidneys from donors < 50 function like standard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled donation, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kidneys from DCD include: implementing organ recovery from emergency department setting; improving familyconsent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.

小香猪DCD边缘供体模型的构建及其供肾病理学观察

目的建立一种小香猪心脏死亡后器官捐献(donation after cardiac death,DCD)供体模型,并对DCD供肾进行病理学评价。方法7只4~6月龄的雄性小香猪(13~17 kg)分为标准供体对照组(C组,n=3)和DCD组(n=4),两组肌注苯巴比妥钠麻醉诱导后,建立耳缘静脉通道,行血压、心电图和氧饱和度(SaO_(2))监测,同时注射丙泊酚、舒芬太尼强化麻醉诱导效果。C组气管插管后机械通气,丙泊酚、瑞芬太尼和顺阿曲库铵维持麻醉,行开腹术摘取肾脏;DCD组静脉推注肝素(300 IU/kg)抗凝,后注射丙泊酚600 mg和顺阿曲库铵10 mg使猪心跳呼吸停止,待心停跳30 min时摘取肾脏。2组肾脏均切成小块组织,4%多聚甲醛固定,行石蜡包埋,采用HE染色,光镜下观察正常肾脏和DCD边缘供体肾脏的病理结果变化并进行组织损伤评分。结果DCD组共成功建模4只猪在注射过量麻醉药后SaO_(2)下降至80%的平均时间为(3.25±1.89)min,心脏骤停平均时间为(7.75±3.10)min;热缺血30 min后获取的DCD边缘供肾与C组供肾相比,肾小管损伤评分增高(P<0.05),肾小球损伤评分均值增高,但差异无统计学意义。结论采用静脉注射过量丙泊酚和顺阿曲库铵的方法可有效建立猪DCD边缘供体模型。

Liver transplantation with grafts obtained after cardiac death-current advances in mastering the challenge

The scarcity of donor livers has increased the interest in donation after cardiac death(DCD) as an additional pool to expand the availability of organs. However, the initial results of liver transplantation with DCD grafts have been suboptimal due to an increased rate of complications, as well as decreased graft survival. These challenges have led to many developments in DCD donation outcome, as well as basic and translational research. In this article we review the unique characteristics of DCD donors, nuances of DCD organ procurement, the effect of prolonged warm and cold ischemia times, and discuss major studies that compared DCD to donation after brain death liver transplantation, in terms of outcomes and complications. We also review the different methods of donor treatment that has been applied to ameliorate DCD organ outcome, and we discuss the role of machine perfusion techniques in organ reconditioning. We discuss the two major perfusionmodels, namely, hypothermic machine perfusion and normothermic machine perfusion; we compare both methods, and delineate their major differences.

DCD供体质量对肝移植术后感染的危险因素分析

目的研究心脏死亡后器官捐献(DCD)供体质量对肝移植术后感染的危险因素。方法选取我院2015年1月至2017年1月128例DCD肝移植受者为研究对象,统计肝移植术受者住院期间感染发生率,根据有无术后感染将受者分组。对所有受者进行为期1年随访,比较感染组与未感染组术后1年生存情况。收集DCD供体年龄、性别、体重指数、有无脂肪肝、热缺血时间、冷缺血时间、血钠、血钾、白蛋白、总胆红素、谷丙转氨酶、谷草转氨酶。结果 128例肝移植受者在住院期间,共63例发生术后感染,感染率为49. 2%。共分离151株病原菌,革兰阳性菌65株,占43. 0%;革兰阴性菌71株,占47. 0%;真菌15株,占9. 9%。术后1年随访中,感染组累积生存率显著低于未感染组(P <0. 05)。感染组体重指数≥24kg/m^2、中或重度脂肪肝供体比例显著高于未感染组(P <0. 05),白蛋白显著低于未感染组(P <0. 05),冷缺血时间、总胆红素显著高于未感染组(P <0. 05)。经Logistic回归分析显示,供体脂肪肝、冷缺血时间、总胆红素是肝移植术后感染的独立危险因素,白蛋白是其独立保护因素。结论供体体重指数、脂肪肝、冷缺血时间、白蛋白、总胆红素等DCD供体质量因素对肝移植术后感染有显著影响。

儿童DCD供肾成人单肾移植与标准DCD供肾移植临床疗效比较研究

目的比较儿童DCD供肾成人单肾移植与标准DCD供肾移植(成人供肾成人单肾移植)的临床疗效。方法回顾性分析本院2011年11月至2014年4月完成的97例DCD供肾移植供受者的临床资料。根据供者年龄将其分为儿童DCD供肾成人单肾移植组(SPKT组,3岁<年龄<18岁,20例)和标准DCD供肾移植组(SCDKT组,年龄≥18岁,73例),比较两组供受者一般情况、受者术后不同时间点血肌酐水平、各种并发症的发生率及移植肾和人的1年存活率。结果 SPKT组供者年龄、体重、移植肾长度显著小于SCDKT组,差异具有统计学意义(P<0.01);SPKT组受者术后1年内蛋白尿发生率显著高于SCDKT组(P<0.01);两组受者移植肾和人的1年存活率比较无统计学差异(P>0.05);供受者其它指标比较均无统计学差异(P>0.05)。结论与标准DCD供肾移植相比,尽管蛋白尿发生率较高,但儿童DCD供肾成人单肾移植近期临床效果良好,远期效果有待进一步研究。

极低龄DCD供肝在婴儿肝移植中的疗效分析

目的评估极低龄儿童心脏死亡器官捐献（DCD）供肝在婴儿肝移植中的疗效。方法收集我院2013年12月~2015年4月应用极低龄DCD供肝行肝移植的11例患儿临床资料,包括供体资料、受体资料及随访资料。结果所有供者年龄均小于2月,11例婴儿肝移植受者年龄4~11月。术后有5例患儿出现并发症,其中肝动脉血栓形成4例,门静脉血栓形成1例,肝性脑病3例,肺炎1例,经治疗后均痊愈出院。所有患者随访均长期健康存活。结论极低龄DCD供肝可以作为婴儿肝移植肝源,但并发症发生率偏高。

边缘供肝面临的机遇与挑战

随着手术技术和术后免疫抑制治疗的不断突破与成熟,肝移植受者和移植物存活率显著提高,供肝短缺已成为限制肝移植临床发展的主要阻碍,如何扩大供肝来源也成为了当前迫切需要解决的问题。高龄供肝、脂肪变性供肝、病毒性肝炎供肝、心脏死亡器官捐献供肝等常见边缘供肝在临床肝移植中的使用已经取得了一定的突破性进展,但边缘供肝的使用仍存在较多限制。因此,本文对边缘供肝的定义,几种常见边缘供肝的应用及研究进展进行综述,探讨目前边缘供肝面临的机遇与挑战,旨在为临床肝移植供者池的扩大提供参考,造福更多终末期肝病患者。

不同时间低温机械灌注对猪DCD模型胰岛提取质量影响研究

目的研究不同时间低温机械灌注对提取胰岛质量的作用。方法本研究于2010-2013年在中国医科大学附属第一医院器官移植研究所进行。制备DCD猪模型并切取胰腺,检测并分析不同时间(0、120、180、240 min)低温机械灌注后提取胰岛的各评估指标(胰岛当量、纯度、活性及胰岛素释放指数)的变化。结果在胰岛当量、活性及纯度方面,低温机械灌注组(120 min组、180 min组、240 min组)均高于非灌注组(0 min组),其中机械灌注180 min组与0 min组间比较各指标差异均有统计学意义(P<0.05);在胰岛素释放方面呈现与其他指标相同趋势,机械灌注180 min组胰岛素释放指数为最高,且与0 min组比较差异有统计学意义(P<0.05)。结论机械灌注后提取胰岛质量明显提高,且在机械灌注180 min时胰岛质量达最佳。

每搏量变异率在DCD肾移植术中容量管理的指导意义

目的探讨每搏量变异率(SVV)指导心脏死亡器官捐献(DCD)肾移植患者术中容量管理的可行性。方法选择2013年9月至2014年6月在天津市第一中心医院行DCD肾移植手术患者60例,随机分为中心静脉压(CVP)组和SVV组各30例。两组患者常规行心电图、脉搏血氧饱和度(Sp O2)、有创动脉血压、CVP监测,SVV组另外通过Flo Trac/Vigileo监测SVV、心排血量(CO)等参数。患者术中全程乳酸林格液或聚明胶肽2~5 ml/(kg·h)维持输液;CVP组遵照《米勒麻醉学》(第7版)补液原则,通过调控输液速度控制CVP在10~15 mm Hg。记录术中患者血流动力学指标、手术时间、失血量、输液量、血管活性药物使用情况。比较两组患者见尿时间、术中尿量、术后24小时尿量、术后并发症、重症监护病房(ICU)停留时间、移植肾脏功能恢复情况以及术后住院时间。结果两组患者移植肾脏成活率、肾功能恢复情况、术中尿量、术后24小时尿量、术后并发症、移植肾脏功能恢复情况以及术后住院时间未见统计学差异。与CVP组相比,SVV组患者术中血流动力学指标更加平稳,液体输注量显著减少(ml:3 327±205比3 550±229,P<0.01),术后ICU停留时间少于CVP组(h:16.4±2.3比18.1±2.7,P<0.05)。结论 SVV较CVP可以更准确地反映肾移植患者术中循环容量状态,且可以预测液体反应性可以减少术中液体输入量、缩短患者术后ICU停留时间。

影响DCD供肝质量的多因素分析

目的分析影响心脏死亡器官捐献(DCD)供肝质量的相关因素。方法回顾性分析67例青岛大学附属医院于2014年7月-2017年9月完成的器官捐献并于本院实施肝移植供者的临床资料,供者资料作为自变量,包括年龄、性别、原发病、救治时间、高血压、糖尿病、吸烟、饮酒、体重指数(BMI)、脂肪肝程度、白蛋白、血清钠、血糖、动脉血氧分压(PaO_2)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST),并收集相应受者术后15天肝功能水平,包括:AST、ALT、总胆红素(TBiL)、直接胆红素(DBi L),上述自变量分别与因变量作Spearman两两相关分析,筛选出显著性相关的变量进行多重线性回归分析,得出回归方程并进行方差分析,评估供肝质量的影响因素。结果年龄、高血压、吸烟、原发病与肝移植术后15天的TBi L显著性相关(r=0.227、2.7、0.338、0.288,均P<0.05),年龄、吸烟与肝移植术后15天DBiL显著性相关(r=2.78、0.26,均P<0.05)。拟合的回归模型:log_(10)TBi L=1.732+0.006×年龄+0.123×(1或0,1表示脑外伤,0表示脑出血)+0.151×(1或0,1表示吸烟,0表示不吸烟),调整R^2=0.224(F=6.962,P<0.01),log_(10)DBi L=1.795+0.011×年龄+0.17×(1或0,1表示吸烟,0表示不吸烟),调整R^2=0.186(F=8.416,P=0.001)。结论供者年龄、吸烟、原发病是影响肝移植术后早期移植肝肝功能异常的危险因素,脑外伤供肝患者肝移植术后总胆红素水平与脑出血供肝患者相比恢复较慢。

大鼠DCD供肝热缺血时间对移植肝的影响

目的评价大鼠心脏死亡器官捐献(DCD)供肝热缺血时间对移植肝的影响。方法建立大鼠DCD供肝原位肝移植模型。根据供肝获取前经历心脏停搏时间的不同,将54只受体大鼠分为3组:对照组(W0组,未经历热缺血)、热缺血10 min组(W10组)、热缺血20 min组(W20组),每组18只。各组大鼠分别于术后1、3、7 d检测血清肝功能[丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)],电子显微镜观察肝细胞及其细胞器,用蛋白质免疫印迹(Western blot)法检测肝组织细胞色素C(Cyt C)和凋亡诱导因子(AIF)的蛋白表达水平。结果随着热缺血时间的延长,肝移植术后1 d,各组大鼠ALT和AST水平急剧上升,与W0组相比,W10组和W20组的ALT和AST水平均明显升高(均为P<0.05)。术后3 d,各组大鼠ALT和AST水平均稍稍下降,与W0组相比,W10组和W20组的ALT和AST水平仍明显较高(均为P<0.05)。术后7 d,各组大鼠ALT和AST水平均再次上升,与W0组相比,W10组和W20组的ALT和AST水平升高更显著(均为P<0.05)。电子显微镜观察发现,随着热缺血时间的延长,肝细胞水肿程度逐渐加重,内质网扩张逐渐加重,线粒体损伤程度加重,W20组尤为严重。术后1 d,3组大鼠肝组织中的AIF和Cyt C蛋白表达水平的比较,差异均无统计学意义(均为P>0.05)。术后3、7 d,与W0组比较,W10组和W20组的AIF与Cyt C蛋白表达水平均较高,差异均有统计学意义(均为P<0.05),且W20组的AIF与Cyt C蛋白表达水平均高于W10组(均为P<0.05)。结论 DCD供肝热缺血主要损伤肝细胞,随着热缺血时间的延长,移植肝肝细胞内线粒体和其他细胞器形态、及线粒体凋亡相关蛋白水平均出现明显变化。

Beneficial Effect of Moderately Increasing Hypothermic Machine Perfusion Pressure on Donor after Cardiac Death Renal Transplantation

Background:Vascular resistance and flow rate during hypotherrnic machine perfusion (HMP)of kidneys is correlated with graft function. We aimed to determine the effects of increasing HMP pressure versus maintaining the initial pressure on kidney transplantation outcomes. Methods:We retrospectively reviewed the data of 76 primary transplantation patients who received HMP-preserved kidneys from 48 donors after cardiac death between September 1,2013,and August 31,2015.HMP pressure was increased from 30 to 40mmHg (1mmHg =0.133kPa)in kidneys with poor flow and/or vascular resistance (increased pressure [IP]group;36 patients);otherwise,the initial pressure was maintained (constant pressure group;40 patients).Finally,the clinical characteristics and transplantation outcomes in both groups were assessed. Results:Delayed graft function (DGF)incidence,1-year allograft,patient survival,kidney function recovery time,and serum creatinine level on day 30 were similar in both groups,with improved flow and resistance in the IP group.Among patients with DGF,kidney function recovery time and DGF duration were ameliorated in the IP group.Multivariate logistic regression analysis revealed that donor hypertension (odds ratio [OR]:1.43,95%confidence interval [CI]:1.02-2.06,P =0.035),donor terminal serum creatinine (OR:1.27,95%C7:1.06-1.62,P =0.023),warm ischemic time (OR:3.45,95%CI:1.97-6.37,P =0.002),and terminal resistance (OR:3.12,95%CI:1.76-6.09,P =0.012)were independent predictors of DGF.Cox proportional hazards analysis showed that terminal resistance (hazard ratio:2.06,95%C1:1.32-5.16,P =0.032)significantly affected graft survival. Conclusion:Increased HMP pressure improves graft perfusion but does not affect DGF incidence or 1-year graft survival.

Outcome of kidney transplantation between controlled cardiac death and brain death donors： a meta-analysis

Background Our goal was to evaluate the outcomes of kidney transplants from controlled cardiac death donors compared with brain death donors by conducting a meta-analysis of cohort studies.Methods The PubMed database and EMBASE were searched from January 1980 to July 2013 to identify studies that met pre-stated inclusion criteria.Reference lists of retrieved articles were also reviewed.Two authors independently extracted information on the designs of the studies,the characteristics of the study participants,and outcome assessments.Results Nine cohort studies involving 84 398 participants were included in this meta-analysis; 3 014 received kidneys from controlled cardiac death donors and 80 684 from brain death donors.Warm ischemia time was significantly longer for the controlled cardiac death donor group.The incidence of delayed graft function was 2.74 times （P 〈0.001） greater in the controlled cardiac death donor group.The results are in favor of the brain death donor group on short-term patient and graft survival while this difference became nonsignificant at mid-term and long term.Sensitivity analysis yielded similar results.No evidence of publication bias was observed.Conclusion This meta-analysis of retrospective cohort studies suggests that the outcome after controlled cardiac death donors is comparable with that obtained using kidneys from brain death donors.

DCD时代肾移植术后耐碳青霉烯类肺炎克雷伯菌感染的治疗经验总结

目的总结心脏死亡器官捐献(DCD)时代肾移植术后耐碳青霉烯类肺炎克雷伯菌(CRKP)感染的临床治疗经验。方法回顾性分析2015年1月至2019年1月行DCD供肾移植术后CRKP感染的17例受者和10例供者临床资料。供、受者均行细菌培养和药敏试验;记录CRKP感染受者的临床表现、治疗及转归情况。结果7例供者感染CRKP,对其预处理后,2例供者CRKP转阴,5例供者CRKP未转阴。所有供肾均接受替加环素+美罗培南+伏立康唑灌洗预防感染。17例CRKP感染的受者中,包括11例血培养阳性、10例尿培养阳性、3例痰培养阳性、3例切口分泌物阳性、3例腹膜后引流液阳性;其临床表现包括发热8例、移植肾动脉破裂出血7例或移植肾动脉内血栓形成1例、膀胱刺激征3例、咳砖红色胶冻样痰1例。接受替加环素+美罗培南治疗5例,移植肾丢失1例,受者死亡4例;接受头孢他啶-阿维巴坦+美罗培南治疗12例,移植肾丢失3例,受者死亡1例。结论CRKP感染供者并非肾移植的绝对禁忌证,提前处理供者感染,受者术后早期给予足量敏感抗生素可以治愈感染,改善肾移植受者预后。

心脏移植的发展现状和新挑战

心脏移植是终末期心力衰竭患者的首选治疗。供者不足一直以来都是限制心脏移植数量增长的主要问题,随着新技术的不断更新和引入,供者池被不断扩大,比如使用年龄较大的供者、丙型肝炎病毒感染的供者、毒品过量致死的供者或心脏死亡器官捐献(DCD)供者的心脏等。与此同时,高龄、多器官功能不全、机械循环支持及人类白细胞抗原抗体致敏受者的比例近几年明显增加。供者数量的不足、受者状况的复杂化、免疫抑制治疗的个体化管理和远期移植物血管病的防治等都是心脏移植领域面临的挑战。本文通过概述现今全球在扩大供者库、提高受者质量、加强排斥反应的诊治和心脏移植物血管病变的预防等方面的新进展,以期有助于改善在等待或已经接受心脏移植的终末期心力衰竭患者的生存时间和生活质量。

心脏死亡器官捐献供肾与亲属活体捐献供肾的移植效果

目的 探讨心脏死亡器官捐献(donation after cardiac death,DCD)供肾与亲属活体捐献(livingdonor,LD)供肾移植术后短期效果的差异,评估DCD供肾移植的可行性及安全性,以便更好地利用DCD来源供肾。方法 选取2017年12月至2023年1月在临沂市人民医院泌尿外科行肾脏移植术后患者,根据供者的来源分为DCD组和LD组。收集两组的临床资料,并比较两组术后不同时间血肌酐变化及术后并发症等发生情况。结果 共纳入患者70例,其中DCD为50例,LD为20例。两组均恢复顺利,术后2周内血肌酐均降至200μmol/L以下,手术时间、住院时间及术后并发症发生率均差异无统计学意义。但DCD组术后2周内血肌酐水平要高于LD组,其中第1~7天及第9天两组血肌酐水平比较差异有统计学意义(P <0.05)。结论 DCD肾移植效果确切,但在术后短期肾功能恢复与LD供肾存在一定的差异,需要加强术前评估。

心脏机械灌注技术的研究现状

高质量的供心是移植成功的先决条件和根本保障,合理的供心保存技术对提升供心质量、改善心脏移植预后具有关键作用。静态冷保存(SCS)是目前移植心脏的标准保存技术,但该技术易造成供心严重的冷缺血损伤,且保存过程中无法评估心脏功能。机械灌注技术作为当前器官保存的重要新型技术,比SCS更符合生理状态,能够在器官保存过程中清除代谢废物、提供代谢需求的基本物质,一定程度延长保存时间、提升保存效果;也能有效评估器官功能,改善心脏移植预后;同时还能修复器官损伤,显著优化器官质量,提高供器官利用率。本文就心脏机械灌注技术的研究现状展开综述。