小肠移植物的保存现状及展望

Present Situation and Progress of Small Intestine Graft Preservation

摘要: 在所有腹部器官移植供体器官中，小肠移植物对冷缺血时限要求最严格，目前低温静态保存技术已经沿用近30年，已经无法满足不断提高的临床需求。进行性加重的缺血–再灌注损伤以及其后伴随的肠黏膜屏障破坏，会直接导致菌群移位、再灌注后综合征以及液体与电解质转移，并增加器官移植术后急性排斥反应风险。时至今日，小肠的保存仍然依靠低温灌注及静态保存，小肠内腔的处理与保存技术仍停留在实验阶段。UW低温静态保存小肠移植物在9 h以内，损伤较轻，但是这个时限难以满足大多数移植中心的实际需要。本文就近年来的相关进展，以及小肠移植物保存改进策略，进行简要介绍。

Abstract: In all abdominal donor organs, small intestine grafts need the shortest preservation time limit for cold ischemia, but cold static preservation technology has been used for almost 30 years and could not meet the clinical needs anymore. Aggravated ischemia-reperfusion injury and subsequent intestinal mucosal barrier damage can directly lead to bacterial displacement, reperfusion syndrome, and fluid and electrolyte metastasis, which could increase the risk of acute rejection post transplantation. Nowadays, the preservation of the small intestine still depends on cold perfusion and static preservation, which didn’t involve the treatment and preservation of the small intestine cavity. Early studies have confirmed that UW low temperature static preservation of small intestine grafts within 9 h, the damage is lighter, but this time limit is difficult to meet the actual needs of most transplant centers. There are few researches on the clinical preservation and IRI of small intestine grafts, and more experimental research, which provides an important reference for the practical application of clinical practice. This article will present the progress of small intestine graft preservation in recent years.