PDF(Pubmed)
Abstract：
In recent years, significant progress has been made in the field of liver machine perfusion. Many large transplant centers have implemented machine perfusion strategies in their clinical routine. Normothermic machine perfusion (NMP) is primarily used to determine the quality of extended criteria donor (ECD) organs and for logistical reasons. The vast majority of studies, which assessed the viability of perfused grafts, focused on hepatocellular injury. However, biliary complications are still a leading cause of post-transplant morbidity and the need for re-transplantation. To evaluate the extent of biliary injury during NMP, reliable criteria that consider cholangiocellular damage are needed. In this review, different approaches to assess damage to the biliary tree and the current literature on the possible effects of NMP on the biliary system and biliary injury have been summarized. Additionally, it provides an overview of novel biomarkers and therapeutic strategies that are currently being investigated. Although expectations of NMP to adequately assess biliary injury are high, scant literature is available. There are several biomarkers that can be measured in bile that have been associated with outcomes after transplantation, mainly including pH and electrolytes. However, proper validation of those and other novel markers and investigation of the pathophysiological effect of NMP on the biliary tree is still warranted.
摘要：
近年来,在肝脏机械灌注领域取得了重大进展。许多大型移植中心已经在其临床常规中实施了机器灌注策略。常规机器灌注（NMP）主要用于确定扩展标准供体（ECD）器官的质量以及出于后勤原因。绝大多数的研究,评估了灌注移植物的生存能力，关注肝细胞损伤。然而,胆道并发症仍然是移植后发病和需要再次移植的主要原因.为了评估NMP期间胆道损伤的程度，需要考虑胆管细胞损伤的可靠标准.在这次审查中,总结了评估胆道树损伤的不同方法以及有关NMP对胆道系统和胆道损伤的可能影响的现有文献。此外,它概述了目前正在研究的新型生物标志物和治疗策略.尽管对NMP充分评估胆道损伤的期望很高，文献很少。有几种生物标志物可以在胆汁中测量，这些生物标志物与移植后的结果有关，主要包括pH和电解质。然而,仍有必要对这些标记物和其他新标记物进行适当验证，并研究NMP对胆道树的病理生理作用。
