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Current techniques and the future of lung preservation
Cryobiology ( IF 2.7 ) Pub Date : 2020-06-01 , DOI: 10.1016/j.cryobiol.2020.04.009
Larissa J Lautner 1 , Darren H Freed 2 , Jayan Nagendran 2 , Jason P Acker 3
Affiliation  

Although lung transplant remains the only option for patients suffering from end-stage lung failure, donor supply is insufficient to meet demand. Static cold preservation is the most common method to preserve lungs in transport to the recipient; however, this method does not improve lung quality and only allows for 8 h of storage. This results in lungs which become available for donation but cannot be used due to failure to meet physiologic criteria or an inability to store them for a sufficient time to find a suitable recipient. Therefore, lungs lost due to failure to meet physiological or compatibility criteria may be mitigated through preservation methods which improve lung function and storage durations. Ex situ lung perfusion (ESLP) is a recently developed method which allows for longer storage times and has been demonstrated to improve lung function such that rejected lungs can be accepted for donation. Although greater use of ESLP will help to improve donor lung utilization, the ability to cryopreserve lungs would allow for organ banking to better utilize donor lungs. However, lung cryopreservation research remains underrepresented in the literature despite its unique advantages for cryopreservation over other organs. Therefore, this review will discuss the current techniques for lung preservation, static cold preservation and ESLP, and provide a review of the cryopreservation challenges and advantages unique to lungs.

中文翻译:

肺保存的当前技术和未来

尽管肺移植仍然是晚期肺衰竭患者的唯一选择,但供体供应不足以满足需求。静态冷藏是在运输到受者的过程中保存肺部最常见的方法;然而,这种方法并不能改善肺质量,只能储存 8 小时。这导致肺可用于捐赠,但由于未能满足生理标准或无法将它们储存足够长的时间以找到合适的接受者而无法使用。因此,由于未能满足生理或相容性标准而导致的肺损失可以通过改善肺功能和储存持续时间的保存方法来减轻。异位肺灌注 (ESLP) 是最近开发的一种方法,它允许更长的存储时间,并已被证明可以改善肺功能,从而可以接受被拒绝的肺进行捐赠。虽然更多地使用 ESLP 将有助于提高供体肺的利用率,但冷冻保存肺的能力将使器官库更好地利用供体肺。然而,尽管肺冷冻保存在冷冻保存方面比其他器官具有独特优势,但在文献中的代表性仍然不足。因此,本综述将讨论当前的肺保存、静态冷保存和 ESLP 技术,并综述肺的低温保存挑战和独特优势。虽然更多地使用 ESLP 将有助于提高供体肺的利用率,但冷冻保存肺的能力将使器官库更好地利用供体肺。然而,尽管肺冷冻保存在冷冻保存方面比其他器官具有独特优势,但在文献中的代表性仍然不足。因此,本综述将讨论当前的肺保存、静态冷保存和 ESLP 技术,并综述肺的低温保存挑战和独特优势。虽然更多地使用 ESLP 将有助于提高供体肺的利用率,但冷冻保存肺的能力将使器官库更好地利用供体肺。然而,尽管肺冷冻保存在冷冻保存方面比其他器官具有独特优势,但在文献中的代表性仍然不足。因此,本综述将讨论目前用于肺保存、静态冷保存和 ESLP 的技术,并对肺独特的低温保存挑战和优势进行综述。
更新日期:2020-06-01
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