新的装置可以延长心脏移植前的生存能力

新的装置可以延长心脏移植前的生存能力

Organ transplantations face many hurdles – a major one being time. From the moment an organ is taken out of a donor and put into ice, the cells in that organ begin to die. This race against time is more often than not lost. The issue is particularly problematic for hearts, with around 70 percent of viable hearts failing to make it into a recipient in time.

器官移植面临许多障碍，其中最主要的是时间。从器官从捐献者体内取出并放入冰块的那一刻起，器官中的细胞就开始死亡。这种与时间的赛跑往往是失败的。这个问题对心脏来说尤其成问题，大约70%的可存活心脏无法及时成为受体。

"The standard of care for heart preservation and transportation is a cooler with a limited preservation time of 4 hours from the time the heart is cross-clamped to the time it reaches the recipient patient. Ischemia (restriction of blood supply to the tissue, causing a lack of oxygen to the tissue, and resulting in cell death) begins immediately after the heart is disconnected from the body. Thus the heart has to be transported immediately to the recipient within the 4-hour period," lead author Dr Rafael Veraza, from the University of Texas Health at San Antonio, told IFLScience.

“心脏保存和运输的护理标准是一个冷却器，从心脏交叉夹紧到到达受体病人有4小时的有限保存时间。缺血(限制组织的血液供应，导致组织缺氧，导致细胞死亡)在心脏与身体分离后立即开始。因此，心脏必须在4小时内被立即运送到受者体内。”该研究的第一作者、来自圣安东尼奥德克萨斯大学卫生学院的Rafael Veraza博士告诉IFLScience。

Alfredo Carpineti

"In effect, by limiting the time to 4 hours, the geographical location where hearts can be matched to the proper recipient, is limited. With a device that can extend the preservation time beyond 4 hours up to 24 hours, it extends the geographic location where hearts can be transported to the proper recipient."

“实际上，通过将时间限制在4个小时，心脏可以匹配到合适的接受者的地理位置是有限的。利用一种可以将心脏保存时间从4小时延长到24小时的设备，心脏可以被运送到合适的接受者那里。”

At the American Association for the Advancement of Science (AAAS) meeting in Seattle, the team presented the results from their new approach that might just slow down the clock. The team announced that their preservation device shows no damage to the heart muscle cells, called cardiomyocytes, after 24 hours in the machine. The tech, called ULiSSES™ (Universal Limb/organ Stasis System for Extended Storage), uses perfusion to keep the cells fed and oxygenated. This delays cell death, which is key to extending the transplant clock.

在西雅图召开的美国科学促进协会(AAAS)会议上，研究小组展示了他们的新方法的结果，这种方法可能会减慢时间。研究小组宣布，他们的保存设备显示，在24小时后，心肌细胞没有受到损伤。这项技术被称为ULiSSES™(通用肢体/器官停滞系统，用于扩展存储)，使用灌注来保持细胞的充盈和充氧。这延缓了细胞死亡，这是延长移植时钟的关键。

“Histology results demonstrated intact cardiomyocyte nuclei, no visible cardiomyocyte damage and no signs of inflammatory cell infiltration,” Dr Veraza wrote in the abstract. “Our proof of concept demonstrates that using a novel oxygenated perfusion machine for 24 hours can maintain cardiac muscle integrity after cardiac death.”

Veraza博士在摘要中写道:“组织学结果显示心肌细胞核完整，心肌细胞无明显损伤，无炎症细胞浸润迹象。”“我们的概念证明表明，使用新型氧灌注机24小时可以保持心脏死亡后心肌的完整性。”

The experiment was performed on five pig hearts placed in ULiSSES™ immediately after their death. The machine kept the hearts beating at 60 pulses per minute and at a temperature of 4°C (39.2°F). The team flooded the hearts with oxygenated Krebs-Henseleit solution, which provided the oxygen and nutrients for the cells.

实验是在五只死后立即放入ULiSSES™的猪心脏上进行的。在4°C(39.2°F)的温度下，心脏以每分钟60次的速度跳动。研究小组用含氧的Krebs-Henseleit溶液注入心脏，为细胞提供氧气和营养。

The team is currently investigating the limitations of such a device as well as if a heart that has been preserved in ice for one hour and then placed in the device remains viable for the full 24-hour period. Perfusion as a method has recently been used in extending the viability of livers, and investigations are underway to find out more about the efficacies of these transplants in humans. Still, more studies are needed to test the device's efficacy on human hearts, which will require official approvals.

研究小组目前正在研究这种装置的局限性，以及在冰中保存一小时，然后放置在装置中的心脏是否可以在24小时内存活。灌注作为一种方法最近已被用于扩大肝脏的生存能力，目前正在进行调查，以发现更多关于这些移植在人类中的有效性。尽管如此，还需要更多的研究来测试该设备对人类心脏的功效，这将需要官方的批准。

In the United States, 114,000 people are currently on the waiting lists for a lifesaving transplant, with a new name added every 10 minutes. On average, the lack of available viable organs costs the lives of 20 people every day.

在美国，目前有11.4万人在等待一项挽救生命的移植手术，每10分钟就会增加一个新名字。平均而言，缺乏可用的可存活器官每天导致20人死亡。