常温及亚低温离体灌流修复边缘供肝的基础及前临床研究

项目名称： 常温及亚低温离体灌流修复边缘供肝的基础及前临床研究

项目编号： No.81470891

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 李建辉

作者单位： 浙江大学

项目金额： 73万元

中文摘要： 肝移植是治疗终末期肝病的有效方法之一，目前供肝短缺矛盾日益凸显。边缘供肝（心亡（DCD）供体、脂肪肝供体，老年供体）的应用一定程度上缓解了这一矛盾，然而大多边缘供肝本身及在供肝获取，保存及移植过程中不可避免的带来各种损伤显著影响移植预后。因此维持良好的器官活性对移植后器官功能恢复及存活至关重要。目前器官保存最常采用的是静态冷保存技术,虽然该方法简单有效,但对于临床日益增加应用的边缘供肝，其器官修复的价值越来越受到质疑。目对机器保存灌流技术的研究方兴未艾。本课题旨在研发基于临床应用的常温及亚低温离体肝脏灌流体系，优化系统模块设置。并对边缘供肝灌流效果进行评价，同时对其保护机制进行研究。我们设想通过研究建立适合临床实践应用的离体器官保存策略，对减少供肝保存损伤、维持供肝最佳活力，更合理有效的利用边缘供肝及完善DCD时代的体外器官评价修复体系，对于移植决策制定及扩大供肝池有重要意义。

中文关键词： 肝移植；肝胆外科；器官保护

英文摘要： Liver transplantation is a life-saving therapy for patients suffering from end-stage liver disease; Despite the major achievements in liver transplantation we are nowadays still facing the persistent problem of shortage of donor organs. The application of the increasing numbers of organs retrieved from marginal organ after cardiac death donors has partially expanded the donor pool. However, how to deal with the deterioration of organ quality and the poor transplantation outcome is the big limitation of the widely using of these organs. Maintaining organ viability is critical for optimal graft function and survival. To date, static cold storage is the most widely used form of preservation of donor liver, due to the simple and effective advantage, however it is doubted to improve the outcome of the marginal liver transplantation in the present era. In this planed project we try to utilize the principles involved in effective preservation and focuses on the basic components and methods for liver preservation to reduce ischemia and preservation related injury. Therefore, we try to prove the beneficial effects of subhypothermic/normothermic machine perfusion system as a new perspective in organ preservation for improving the marginal liver transplantation outcome through the pre-clinical studies, and to investigate the potential mechanism of interventions before or during organ preservation. In addition, we also try to investigate the biomarkers in donor plasma and in machine preservation solution, which may assess the machine perfusion characteristics and predict the outcome for liver grafts recovered from marginal donors.

英文关键词： liver;Hepatobiliary Surgery;organ preservation