PDF(Pubmed)
Abstract：
Organ transplantation has enhanced the length and quality of life of patients suffering from life-threatening organ failure. Donors deceased after brain death (DBDDs) have been a primary source of organs for transplantation for a long time, but the need to find new strategies to face organ shortages has led to the broadening of the criteria for selecting DBDDs and advancing utilization of donors deceased after circulatory death. These new sources of organs come with an elevated risk of procuring organs of suboptimal quality. Whatever the source of organs for transplant, one constant issue is the occurrence of ischemia-reperfusion (IR) injury. The latter results from the variation of oxygen supply during the sequence of ischemia and reperfusion, from organ procurement to the restoration of blood circulation, triggering many deleterious interdependent processes involving biochemical, immune, vascular and coagulation systems. In this review, we focus on the roles of thrombo-inflammation and coagulation as part of IR injury, and we give an overview of the state of the art and perspectives on anticoagulant therapies in the field of transplantation, discussing benefits and risks and proposing a strategic guide to their use during transplantation procedures.
摘要：
器官移植提高了危及生命的器官衰竭患者的寿命和生活质量。脑死亡（DBDD）后死亡的供体长期以来一直是移植器官的主要来源，但是，需要寻找新的策略来应对器官短缺，从而扩大了选择DBDD的标准，并促进了循环性死亡后死亡的供体的利用。这些新的器官来源伴随着采购质量欠佳的器官的风险增加。不管移植器官的来源是什么,一个持续的问题是缺血再灌注(IR)损伤的发生。后者是由于缺血和再灌注过程中氧供应的变化，从器官获取到血液循环的恢复，引发许多有害的相互依存的过程，涉及生化，免疫，血管和凝血系统。在这次审查中,我们关注血栓炎症和凝血作为IR损伤的一部分的作用，我们概述了移植领域的最新技术和抗凝治疗观点，讨论利益和风险，并提出在移植过程中使用它们的战略指南。
