Solid organ transplantation is limited by suitable donor organ availability and the geographic limitations that lead to prolonged ischemic times. Ex vivo organ perfusion is an evolving technology that enables assessme...Solid organ transplantation is limited by suitable donor organ availability and the geographic limitations that lead to prolonged ischemic times. Ex vivo organ perfusion is an evolving technology that enables assessment of organ function prior to transplantation. As a byproduct, overall out of body organ times are able to be extended. The future implications organ assessment and repair centers utilizing this technology are discussed.展开更多
Glucocorticoids(GCs)have been the mainstay of immunosuppressive therapy in solid organ transplantation(SOT)for decades,due to their potent effects on innate immunity and tissue protective effects.However,some SOT cent...Glucocorticoids(GCs)have been the mainstay of immunosuppressive therapy in solid organ transplantation(SOT)for decades,due to their potent effects on innate immunity and tissue protective effects.However,some SOT centers are reluctant to administer GCs long-term because of the various related side effects.This review summarizes the advantages and disadvantages of GCs in SOT.PubMed and Scopus databases were searched from 2011 to April 2021 using search syntaxes covering“transplantation”and“glucocorticoids”.GCs are used in transplant recipients,transplant donors,and organ perfusate solution to improve transplant outcomes.In SOT recipients,GCs are administered as induction and maintenance immunosuppressive therapy.GCs are also the cornerstone to treat acute antibody-and T-cell-mediated rejections.Addition of GCs to organ perfusate solution and pretreatment of transplant donors with GCs are recommended by some guidelines and protocols,to reduce ischemia-reperfusion injury peri-transplant.GCs with low bioavailability and high potency for GC receptors,such as budesonide,nanoparticle-mediated targeted delivery of GCs to specific organs,and combination use of dexamethasone with inducers of immuneregulatory cells,are new methods of GC application in SOT patients to reduce side effects or induce immune-tolerance instead of immunosuppression.Various side effects involving different non-targeted organs/tissues,such as bone,cardiovascular,neuromuscular,skin and gastrointestinal tract,have been noted for GCs.There are also potential drug-drug interactions for GCs in SOT patients.展开更多
文摘Solid organ transplantation is limited by suitable donor organ availability and the geographic limitations that lead to prolonged ischemic times. Ex vivo organ perfusion is an evolving technology that enables assessment of organ function prior to transplantation. As a byproduct, overall out of body organ times are able to be extended. The future implications organ assessment and repair centers utilizing this technology are discussed.
文摘Glucocorticoids(GCs)have been the mainstay of immunosuppressive therapy in solid organ transplantation(SOT)for decades,due to their potent effects on innate immunity and tissue protective effects.However,some SOT centers are reluctant to administer GCs long-term because of the various related side effects.This review summarizes the advantages and disadvantages of GCs in SOT.PubMed and Scopus databases were searched from 2011 to April 2021 using search syntaxes covering“transplantation”and“glucocorticoids”.GCs are used in transplant recipients,transplant donors,and organ perfusate solution to improve transplant outcomes.In SOT recipients,GCs are administered as induction and maintenance immunosuppressive therapy.GCs are also the cornerstone to treat acute antibody-and T-cell-mediated rejections.Addition of GCs to organ perfusate solution and pretreatment of transplant donors with GCs are recommended by some guidelines and protocols,to reduce ischemia-reperfusion injury peri-transplant.GCs with low bioavailability and high potency for GC receptors,such as budesonide,nanoparticle-mediated targeted delivery of GCs to specific organs,and combination use of dexamethasone with inducers of immuneregulatory cells,are new methods of GC application in SOT patients to reduce side effects or induce immune-tolerance instead of immunosuppression.Various side effects involving different non-targeted organs/tissues,such as bone,cardiovascular,neuromuscular,skin and gastrointestinal tract,have been noted for GCs.There are also potential drug-drug interactions for GCs in SOT patients.
