دوره 37، شماره 557: هفته اول اسفند ماه 1398:1388-1400

پیشرفت‌های اخیر در روش‌ها و محلول‌های نگه‌دارنده‌ی اعضا به منظور استفاده در پیوند کبد و کلیه

زهراسادات جمدی , پری‌ناز پرهیزگار , قاسم یزدان‌پناه , طاهره طیبی , رقیه تاراسی , حسن نیک‌نژاد

DOI: 10.22122/jims.v37i557.12342

چکیده


مقدمه: با توجه به پیشرفت‌های اخیر در روش‌های جراحی پیوند، تعداد پیوند اعضا افزایش یافته است. روش و محلول نگهداری عضو پیوندی از عوامل تعیین کننده‌ی نتایج پیوند می‌باشند. در این مقاله‌ی مروری، نحوه‌ی نگهداری اعضای پیوندی و محلول‌های مورد استفاده در این خصوص مورد ارزیابی و مقایسه قرار می‌گیرند.

روش‌ها: جستجو در بانک‌های داده‌ای PubMed، Science direct و Google scholar با کلید واژه‌های Preservation solutions،Organ transplantation ، Kidney، Pancreas و Liver صورت گرفت و نتایج انواع مطالعات انجام شده در این زمینه تا سال 2019 مورد بررسی قرار گرفت.

یافته‌ها: هدف از ساخت محلول‌های نگه‌دارنده، به حداقل رساندن این آسیب‌ها با به حداقل رساندن تورم سلولی و فعالیت پمپ‌های غشایی و در عین حال، تأمین انرژی مورد نیاز سلول می‌باشد و همچنین، با توجه به شرایط کمبود عضو و گاهی فواصل مکانی طولانی که بین فرد دهنده و گیرنده‌ی عضو وجود دارد، مطالعات متعددی جهت بهینه کردن روش‌ها و محلول‌های نگه‌دارنده برای افزایش زمان نگهداری عضو در جریان است. محلول‌های ساخته شده بر پایه‌ی الکترولیت‌ها، آنتی‌اکسیدان‌ها و ساکاریدها می‌باشد. در حال حاضر، محققان بسیاری درصدد یافتن روش‌هایی برای بهینه کردن محلول با استفاده از مهار کننده‌های مرگ سلولی در سطح ژنی و پروتئینی نظیر siRNA اختصاصی برای کاسپازهای 3 و 8 می‌باشند.

نتیجه‌گیری: با وجود تمام تلاش‌ها، این محلول‌ها کارایی کافی جهت نگهداری طولانی مدت عضو را ندارند. بنابراین، لازم است تغییراتی برای بهبود عملکرد هر چه بیشتر این روش‌ها و محلول‌ها ایجاد شود.


واژگان کلیدی


پیوند اعضا؛ محلول نگه‌دارنده؛ کبد؛ کلیه

تمام متن:

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مراجع


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