(精编)【体外膜肺ECMO精品课件】 Horizon Scanning on organ perfusion教学课件.pptVIP

Horizon Scanning on organ perfusion Kidneys David Talbot Maastricht II and Maastricht III Cold machine perfusion its future Non used kidneys Summary of NHBD Kidney Programme 1998- 13th November 2006 NHBD 105 Donors ( 210 kidneys) 138 Renal Transplants 72 Non used Kidneys II III IV 100 96 14 43 77 14 57 15 0 NHBD Dual donors Recipients of dual kidneys 13 4 0 13 4 0 Primary WIT ( minutes) 22.2 + 1.0 Secondary WIT (minutes) 37.7 + 1.0 CIT (minutes) 1486 + 34.8 Survival rates (%) First Year Third Year KIDNEY PATIENT 88.4 91.4 84.7 88.7 Transplant Rate ----- Cat II – 45.1% Cat III – 82.1% Cat IV -100% Overall Transplants of NHBD = 62.8% Maastricht II/III distribution in Newcastle Summary from France 48% conversion rate from potential MII donors 61% of these kidneys utilised (29% of total) Steady increase in proportion of donors managed by normothermia Best outcome of grafts in 2007-9 when 8% normothermia Utilisation rate hasn’t changed enormously for kidneys with addition of normothermia (11 Livers so far from 3 units, 2 PNF) Cold machine perfusion for MIII DCD Cyril Moers, Jacqueline M Smits, Mark-Hugo J Maathuis, Jurgen Treckmann, et al. The New England Journal of Medicine. Boston: Jan 1, 2009. Vol. 360, Iss. 1; pg. 7 Improved DGF with machine perfusion Improved graft outcome DCD and DBD pairs Perfusate different for static storage Cold Machine Perfusion Versus Static Cold Storage of Kidneys Donated After Cardiac Death: A UK Multicenter Randomized Controlled Trial. Watson CJ et al. [Am J Transplant] 2010 Sep; Vol. 10 (9), pp. 1991-9. DCD paired kidneys Solutions matched Duration of machine perfusion sometimes short No difference in outcome Son of PPART Close to 100 kidneys recruited Machine perfused from donor hos