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新裝置可延長心臟移植前的存活時間

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2020年02月25日

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New Device May Extend The Viability Of Hearts Before Transplantation

新裝置可延長心臟移植前的存活時間

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.

器官移植面臨許多障礙——時間是一個主要障礙。從器官從供體中取出并放入冰中的那一刻起,器官中的細胞就開始死亡。這場與時間的賽跑往往是失敗的。這個問題對心臟來說尤其有問題,大約70%的可存活心臟無法及時轉化為受體。

"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.

“心臟保存和運輸的護理標準是一個冷卻器,保存時間從心臟交叉夾持到到達受者患者的時間限定為4小時。缺血(組織供血受限,組織缺氧,導致細胞死亡)在心臟與身體斷開后立即開始。因此,心臟必須在4小時內被立即運送到接受者體內。”來自圣安東尼奧德克薩斯大學健康中心的主要作者Rafael Veraza博士告訴IFLScience。

新裝置可延長心臟移植前的存活時間

"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."

“實際上,通過將時間限制在4小時內,心臟與適配者的地理位置將非常有限。通過一種可以將保存時間延長4小時到24小時的設備,它可以增加將心臟運送到合適接受者的地理位置。”

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.

在西雅圖舉行的美國科學促進協會(AAAS)會議上,研究小組展示了他們新方法的結果,這種方法可能會使時間變慢。研究小組宣布,他們的保存設備在機器中放置24小時后,對心肌細胞(稱為心肌細胞)沒有損傷。這項叫做尤利斯™ (通用肢體/器官停滯系統,用于長期儲存)的技術,利用灌注保持細胞供氧。這延緩了細胞死亡,這是延長移植時間的關鍵。

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.

研究小組目前正在調查這種裝置的局限性,以及一顆在冰中保存了一個小時,然后放入裝置的心臟是否在整個24小時內都是可行的。灌注作為一種方法最近被用于延長肝臟的生存能力,目前正在進行調查,以進一步了解這些移植在人類中的效果。不過,還需要更多的研究來測試這種設備對人類心臟的功效,這需要官方的批準。

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.

在美國,目前有11.4萬人在等待一項挽救生命的移植手術,每10分鐘就會增加一個新名字。平均而言,缺乏可用的可存活器官每天導致20人死亡。


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