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

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی پزشکی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 پزشکی عمومی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 دانشجوی دکتری تخصصی، گروه فارماکولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

4 پژوهشگر پسادکتری، گروه فارماکولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

5 دانشیار، گروه فارماکولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

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.

کلیدواژه‌ها

عنوان مقاله [English]

Recent Advances in Organ Preservation Solutions and Methods for Using in Liver and Kidney Transplantation

نویسندگان [English]

  • Zahra Jamadi 1
  • Parinaz Parhizgar 2
  • Ghasem Yazdanpanah 2
  • Tahereh Tayebi 3
  • Roghayeh Tarasi 4
  • Hassan Niknejad 5
1
2
3
4
5
چکیده [English]

Background: The organ transplantation has been developed due to recent advances in transplantation surgery. The method of preservation and the type of preserving solution are determining factors in the outcome of the transplantations. In this review article, we evaluated the process of organ preservation, and compared the employed storage solutions.Methods: The relevant articles published up to the end of 2019 were collected by searching in PubMed, Science Direct, and Google Scholar databases using terms “Preservation Solutions”, “Organ Transplantation”, “Kidney”, “Pancreas”, and “Liver”.Findings: The aim of developing preservation solutions is to minimize the damage through minimizing the cellular edema; decreasing the function of the membrane pumps, and supplying enough energy for viable cells. Additionally, the two problems of organ shortage for transplantation and time period from taking the organ in the procurement organization to delivering it to the transplant center are enough to encourage scientists to improve preservation methods and solutions for prolonging organ preservation time. The main building blocks of preservation solutions are electrolytes, antioxidants, and saccharides. Currently, there are many efforts to optimize solutions by employing cell death inhibitors such as specific siRNA for caspase 3 and caspase 8.Conclusion: In spite of all the efforts, these solutions do not have enough efficiency in preserving the organs for long periods. Hence, it is necessary to optimize preservation methods and solutions’ features to improve their functions.

کلیدواژه‌ها [English]

  • Organ transplantation
  • Organ preservation solution
  • Liver
  • Kidney

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مجله دانشکده پزشکی اصفهان
دوره 37، شماره 557 - شماره پیاپی 557
بهمن و اسفند 1398
صفحه 1388-1400

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  • تاریخ دریافت: 09 مهر 1398
  • تاریخ بازنگری: 12 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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