Öz
Transplantasyon için bekleyen hasta sayısı, elde edilen organların çok üstüne çıkmıştır. Organları korumak için geliştirilen teknoloji de önemli derecede gelişmiştir. Organların çıkartılması, korunması ve nakledilmesi sırasında, iskemi ve hipotermiye bağlı hasar meydana gelir. Organ koruma tekniklerinin amacı, bu hasarı en aza indirmek, organ fonksiyonu ve graft yaşama süresini en iyi duruma getirmektir. Hipotermik koruma için iki teknik kullanılır; basit soğuk saklama ve sürekli hipotermik perfüzyon. Basit soğuk saklamada, organ soğuk koruyucu sıvı ile yıkanır ve içinde aynı sıvının olduğu torbaya konulur. Bu torba, içinde kırılmış buzların olduğu ikinci bir torbaya yerleştirilir. Sürekli hipotermik perfüzyonda, organ içinde sürekli basınçla perfüzyonu sağlayan bir makine kullanılır. Bu makalede organ korunmasının ilkeleri, patofizyolojisi ve teknikleri tartışılarak, bugünkü transplantasyonda kullanılan çeşitli koruyucu sıvılar tartışılmıştır.
Kaynakça
- McBride MA, Harper AM, Taranto SE. The OPTN waiting list, 1988-2002. Clin Transpl 2003;53–64.
- Gjertson DW. Look-up survival tables for living- donor renal transplants: OPTN/UNOS data 1995–2002. Clin Transpl 2003;337–386.
- Belzer FO, Southard JH. Principles of solid-organ preservation by cold storage. Transplantation 1988 Apr;45(4):673–676.
- Pegg. DE. Organ Preservation Surg Clin N Amer 1986;66(3):617–632.
- Starzl TE. History of Clinical Transplantation. World J Sur 2000;24(7):759-782.
- Belzer FO. Evaluation of preservation of intra-abdominal organs. Transplan Proc 1993;25(4):2527–2530.
- Clavien PA, Harvey PR, Strasberg SM. Preservatin and reperfusion injuries in liver allografts. An overview and synthesis of current studies. Transplantation 1992 May;53(5):957–978.
- Yalın A, Arbak S, Ercan F. Preservation of liver with Euro-Collins solution; Evaluation of ultrastructural alterations. Marmara Med J 1999;12(1):29-31.
- Ercan F, Yalın A, Arbak S. Morphological evaluation of heart preserved in Euro_Collıns solution. Med Bull Istanbul Med Fac 1999;32(2):139–143.
- Öner S, Ercan F, Arbak S, Yalın A. A scanning electron microscopic study of cold-storage stored small bowel: Comparison of Euro-Collins and Lactated Ringer Solutions. Proc Scanning 2000;22(2):136–137.
- Kimblat PO, Sjöberg T, Massa G, et al. High potassium content in organ preservation solutions cause strong pulmonary vasoconstraction. Ann Thoracic Surg 1999;52:523-528.
- Yalın A, Gürsoy E. Ultrastructural observations on hypothermic preservation of canine kidney. Tr J Med Sciences. 1994;20:215–220.
- Yalın A, Gürsoy E. Pankreasın basit-hipotermik ortamda korunmasına bağlı morfolojik (ultrastrüktüel) değişiklikler. Klinik ve Deneysel Cerrahi Derg 1992;1(1):1-3
- Lee C Y, Mangino MJ. Preservation methods for kidney and liver. Organogenesis 2009;5(3):105-112.
- McAnulty JF, Vreugdenhil PK, Southard J.H, Bezler FO. Use of UW cold storage solution for machine perfusion of kidneys. Transplant Proc 1990; 22(2):458–459.
- Collins GM, Bravo-Shugarman M, Terasaki Pİ. Kidney preservation for transplantation. I.24-hour storage in rabbits. Transplant Proc 1969;1(3):801–807.
- Collins GM, Bravo-Shugarman, Terasaki Pİ. Inital perfusion and 30 hours ice storage. Lancet 1969 Dec 6;2(7632):1219–1222
- Mees N, Southard JH, Bezler FO. Inhibition of ischemic induced cellular swelling in kidney cortex tissue by lactobionate anions. J Trauma 1982;22:118-120
- McAnulty JF, Reid TW, Waller KR, et al. Successful six-day kidney preservation using trophic factor supplemented media and simple cold storage. Am J Transplant 2002; 2:712–718.
- Belzer F, Ashby B, Dunphy J. 24-hour and 72-hour preservation of canine kidneys. Lancet 1967;2:536–538.
- Friend P, Imber C, Lopez I. Normotermic perfusion of the isolated liver. Transplant Proc 2001;33(7)3436–3438.
- Karlsson JO. Cryopreservation; freezing and vitrifi cation. Science 2002;296(5568): 655–656.
Öz
The growth in the number of patients who are waiting for an organ transplantation has outpaced the supply of available organs. The technology of organ preservation has improved considerably. The injury of the organs during recovery, preservation and transplantation occurs primarily as a result of ischemia and hypothermia. Techniques for organ preservation serve to minimize this damage to promote optimal graft survival and function. With simple cold storage, the organ is flushed with cold preservative solution and placed in a sterile bag immersed in the solution. The sterile bag is placed inside another bag that contains crushed ice. A specific machine is used, which provides consistent pressure, during the continuous perfusion. In this article, the pathophysiology, techniques and the principles of the organ preservation will be discussed with various preservation solutions which are currently used for transplantation.
Anahtar Kelimeler
Kaynakça
- McBride MA, Harper AM, Taranto SE. The OPTN waiting list, 1988-2002. Clin Transpl 2003;53–64.
- Gjertson DW. Look-up survival tables for living- donor renal transplants: OPTN/UNOS data 1995–2002. Clin Transpl 2003;337–386.
- Belzer FO, Southard JH. Principles of solid-organ preservation by cold storage. Transplantation 1988 Apr;45(4):673–676.
- Pegg. DE. Organ Preservation Surg Clin N Amer 1986;66(3):617–632.
- Starzl TE. History of Clinical Transplantation. World J Sur 2000;24(7):759-782.
- Belzer FO. Evaluation of preservation of intra-abdominal organs. Transplan Proc 1993;25(4):2527–2530.
- Clavien PA, Harvey PR, Strasberg SM. Preservatin and reperfusion injuries in liver allografts. An overview and synthesis of current studies. Transplantation 1992 May;53(5):957–978.
- Yalın A, Arbak S, Ercan F. Preservation of liver with Euro-Collins solution; Evaluation of ultrastructural alterations. Marmara Med J 1999;12(1):29-31.
- Ercan F, Yalın A, Arbak S. Morphological evaluation of heart preserved in Euro_Collıns solution. Med Bull Istanbul Med Fac 1999;32(2):139–143.
- Öner S, Ercan F, Arbak S, Yalın A. A scanning electron microscopic study of cold-storage stored small bowel: Comparison of Euro-Collins and Lactated Ringer Solutions. Proc Scanning 2000;22(2):136–137.
- Kimblat PO, Sjöberg T, Massa G, et al. High potassium content in organ preservation solutions cause strong pulmonary vasoconstraction. Ann Thoracic Surg 1999;52:523-528.
- Yalın A, Gürsoy E. Ultrastructural observations on hypothermic preservation of canine kidney. Tr J Med Sciences. 1994;20:215–220.
- Yalın A, Gürsoy E. Pankreasın basit-hipotermik ortamda korunmasına bağlı morfolojik (ultrastrüktüel) değişiklikler. Klinik ve Deneysel Cerrahi Derg 1992;1(1):1-3
- Lee C Y, Mangino MJ. Preservation methods for kidney and liver. Organogenesis 2009;5(3):105-112.
- McAnulty JF, Vreugdenhil PK, Southard J.H, Bezler FO. Use of UW cold storage solution for machine perfusion of kidneys. Transplant Proc 1990; 22(2):458–459.
- Collins GM, Bravo-Shugarman M, Terasaki Pİ. Kidney preservation for transplantation. I.24-hour storage in rabbits. Transplant Proc 1969;1(3):801–807.
- Collins GM, Bravo-Shugarman, Terasaki Pİ. Inital perfusion and 30 hours ice storage. Lancet 1969 Dec 6;2(7632):1219–1222
- Mees N, Southard JH, Bezler FO. Inhibition of ischemic induced cellular swelling in kidney cortex tissue by lactobionate anions. J Trauma 1982;22:118-120
- McAnulty JF, Reid TW, Waller KR, et al. Successful six-day kidney preservation using trophic factor supplemented media and simple cold storage. Am J Transplant 2002; 2:712–718.
- Belzer F, Ashby B, Dunphy J. 24-hour and 72-hour preservation of canine kidneys. Lancet 1967;2:536–538.
- Friend P, Imber C, Lopez I. Normotermic perfusion of the isolated liver. Transplant Proc 2001;33(7)3436–3438.
- Karlsson JO. Cryopreservation; freezing and vitrifi cation. Science 2002;296(5568): 655–656.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Collection |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2011 |
| Yayımlandığı Sayı | Yıl 2011Sayı: 1 |