Увеличит ли аппаратная перфузия печени количество донорских органов, пригодных для трансплантации?

Во всем мире наблюдается тенденция к росту числа пациентов, ожидающих трансплантацию печени, несмотря на увеличение общего количества операций по трансплантации печени. Решение проблемы дефицита донорских органов возможно за счет использования органов от маргинальных доноров, а именно органов, изъятых после остановки сердца, органов с большим процентом жирового гепатоза, а также органов от доноров в возрасте старше 60 лет. Основная причина отказа от их применения – риск развития тяжелых осложнений и неблагоприятного исхода операции. Статическая холодовая консервация на сегодняшний день – основной метод защиты донорских органов от тепловых повреждений, обладающий достаточно эффективными протективными свойствами. В то же время продолжительность холодовой консервации имеет ограниченный временной интервал. Всегда существует неопределенность относительно жизнеспособности органа. Современные методы оценки донорских органов – анамнез донора, лабораторные данные, визуальный осмотр и морфология – не позволяют достоверно прогнозировать функцию печени после трансплантации. В связи с этим разработка методов консервации органа после изъятия, которые не ухудшают качество органа или даже способны восстановить утраченные функции, является актуальной. Аппаратная перфузия печени представляет собой одну из новых концепций, направленных на решение данной проблемы. В статье освещен международный опыт применения аппаратной перфузии донорской печени за последние 15 лет. Аппаратная перфузия представляет собой перспективное направление развития трансплантологии, позволяющее сократить дефицит донорских органов и улучшить их качество.

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