CN107156109A - A kind of isolated organ preserves system - Google Patents
A kind of isolated organ preserves system Download PDFInfo
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- CN107156109A CN107156109A CN201710399466.7A CN201710399466A CN107156109A CN 107156109 A CN107156109 A CN 107156109A CN 201710399466 A CN201710399466 A CN 201710399466A CN 107156109 A CN107156109 A CN 107156109A
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Classifications
-
- A—HUMAN NECESSITIES
- A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
- A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
- A01N1/00—Preservation of bodies of humans or animals, or parts thereof
- A01N1/02—Preservation of living parts
- A01N1/0236—Mechanical aspects
- A01N1/0242—Apparatuses, i.e. devices used in the process of preservation of living parts, such as pumps, refrigeration devices or any other devices featuring moving parts and/or temperature controlling components
-
- A—HUMAN NECESSITIES
- A01—AGRICULTURE; FORESTRY; ANIMAL HUSBANDRY; HUNTING; TRAPPING; FISHING
- A01N—PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF; BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES; PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
- A01N1/00—Preservation of bodies of humans or animals, or parts thereof
- A01N1/02—Preservation of living parts
- A01N1/0236—Mechanical aspects
- A01N1/0242—Apparatuses, i.e. devices used in the process of preservation of living parts, such as pumps, refrigeration devices or any other devices featuring moving parts and/or temperature controlling components
- A01N1/0247—Apparatuses, i.e. devices used in the process of preservation of living parts, such as pumps, refrigeration devices or any other devices featuring moving parts and/or temperature controlling components for perfusion, i.e. for circulating fluid through organs, blood vessels or other living parts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
Abstract
The present invention relates to technical field of medical equipment, specifically a kind of isolated organ preserves system, including donor self-blood collection device, the anti-phase beating pump of mutual pull, first roller list pump, oxygenator, isolated organ insulation, blood warming equipment, apparatus of oxygen supply, filter, waste fluid bag, urine collecting and bile collection device.The beneficial effects of the invention are as follows, the present invention is the anti-phase beating pump of mutual pull based on a kind of new blood pump, membrane oxygenator, filter, roller list pump and necessary monitoring inductor are integrated, a kind of biomimetic store method of isolated organ and preservation system are proposed using donor self-blood.For the acquisition methods and insulating heating device of this isolated organ matched especially set out.Purpose is the holding time for extending isolated organ (liver, kidney) to greatest extent, is readily transported, repairs, and improves transplanting success rate and the survival rate of acceptor.
Description
Technical field
The present invention relates to technical field of medical equipment, specifically a kind of isolated organ preserves system.
Background technology
Organ transplant is the major progress of 20th century physianthropy science, and the treatment to various whole latter stage organ diseases is brought
Wish.At present, the various organ transplants that the whole world has been carried out are more than 700,000 (secondary).With the development of surgical technic and new
The appearance of type immunodepressant, the survival rate of organ transplant is increased substantially, and is waited the patient populations of transplanting to be subjected and is increased year by year,
In order to alleviate the contradiction of organ shortage, Heart death donor (DCD) is increasingly becoming the vitals source of organ transplant, therefore, faced
Higher requirement is proposed to the Techniques of preserving of organ on bed.Organ Techniques of preserving mainly have static cold Techniques of preserving (SCS) and
Machine perfusion (MP).
The goldstandard that current organ is preserved is SCS, with simple to operate, using safe, cheap and preservation effect compared with
Good the advantages of, conventional preservation liquid has UW liquid, Hik liquid and Celsior liquid etc..
MP proposes first in nineteen sixty by professor Belvet, different from SCS be by the intrinsic vascular system of organ to
The continuous dynamic perfusion of organ is given, originally because MP system operatios are complicated, form is heavy, adds Marginal donor liver using less research
It is once lukewarm.
One side DCD organs are because there is inevitable warm ischemia time in it, and the time is referred to as " no-touch
time”.Therefore the metaboilic level of organ inner tissue cell can not lower because of hypothermia perfusion at once, a large amount of metabolite aggregations,
Conventional cryogenic adds the method that immersion bubble is preserved that preserves, and cell still maintains the metabolism of reduced levels, and nutriment gradually disappears
Consumption, metabolite localized clusters in organ, so as to cause intraorganic cell to be in stress situation, accelerate the apoptosis of cell,
Blood supply is restored after the completion of transfer operation, and a large amount of oxygen are carried along into donor organ by red blood cell, inevitably
Cause respiratory burst, cause serious ischemical reperfusion injury, the time limit that organ is preserved, there are strict requirements, organ preserves the stage
The consumption of oxygen and nutriment will further aggravate damage, have a strong impact on prognosis.On the other hand, at present due to the spy of organ donation
Different property and uncertainty, the organ transplant preoperative preparation time are short.And due to donated organs, especially some rare distribution type
Organ shortage, many patients are dead in waiting time.Therefore, the holding time of isolated organ is extended as far as possible, then favorably
In improving preoperative every inspection, while helping to select most suitable organ graft recipient, ensure surgical effect to greatest extent.
Existing organ save set, which can not be met, to be actually needed.
With the progress of medical engineering, MP intends ecology will be more and more true to nature, and the system integration and intellectuality will also turn into
May.In in vitro Liver Allograft Preservation compared to SCS, machine perfusion has prominent advantage, and 1., which maintain vescular bed unobstructed 2. to improve, rinses
It is to supply liver matter that effect 3., which reduces ischemical reperfusion injury (IRI) and preferably preserved for the real-time dynamic monitoring graft function of liver 4.,
Amount, which is evaluated, provides that the lasting oxygen of window phase 5. is closed and pharmaceutical intervention 6. saves DCD and definitely outer for liver (ECD) extension graft guarantor
Deposit the time limit and supply liver pond (donor pod).
Machine perfusion can be divided into cryogenic machine perfusion (Hypothermic according to maintenance temperature difference in filling process
Machine perfusion, HMP) maintain temperature be 4-6 DEG C, Mild Hypothermal machine perfusion (Subnormothermic machine
Perfusion, SMP) maintain 20 DEG C of temperature, normal temperature machine perfusion (Normothermic machine perfusion, NMP) dimension
Hold 32-37 DEG C of temperature.
Existing machine perfusion has Lifeport hepatic transports device (Organ Recovery Systems Zaventem
) and Liver Assist equipment (Organ Assist BV Groningen The Netherlands) normal temperature machine Belgium
It is perfused with OrganOx systems (OrganOx Ltd, Oxford uk).These products are in preceding clinical investigation phase, also without city
Sell.
The research of domestic this respect only has fragmentary animal level also in the starting stage and reported.The current only First Academy of Zhejiang University,
The document reports such as the Central-South hospital in Wuhan, Tianjin central hospital, the Zhong Shan First Academy, Jiangsu Prov. People's Hospital.Show according to the study, liver kidney
Joint preservation effect is more preferably.
Another organ, which is saved as, in body preserves form, i.e. drug application and modem life or organ dysfunction and support system dimension
The vegetative state of donor is held, once ripe completes transplanting.But during being preserved in body, often occur it is serious after
Hair infection or the MSOF of a certain organ, cause overall preserve to fail, and then cause donor organ to waste and graft failure.
The somewhat expensive of body preservation, risk are larger.
It is high-quality, without lesion, flawless donor organ be ensure to transplant successfully, the premise of survival of recipient.Explore a kind of
Efficiently, controllable, economic isolated organ, which preserves system and had by the donor organ store method of the system operatio, especially must
Right Special Significance.
The content of the invention
Circulation power is used as using continuous pulsation pump it is an object of the invention to overcome the deficiencies of the prior art and provide one kind
To promote donor self-blood, isolated organ persistently obtains oxygen through membrane oxygenation and supplied and nutrient, while cell metabolite can be through certainly
Right pipeline discharge, the isolated organ that can be purified if necessary through haemodiafilter preserves system.
In order to achieve the above object, system is preserved the invention provides a kind of isolated organ, including donor self-blood is received
Acquisition means, the mutual anti-phase beating pump of pull, the first roller list pump, oxygenator, isolated organ insulation, blood warming equipment, oxygen supply dress
Put, filter, waste fluid bag, urine collecting and bile collection device, wherein：
The isolated organ insulation, blood warming equipment include transparent heat-insulation lid, medical silica-gel film and casing, wherein：
The transparent heat-insulation, which is covered, opens up some perforates, and the cover edge installation leakproof cassette rubber of the transparent heat-insulation lid is close
Seal, the medical silica-gel film is located at the inner side of the leakproof cassette rubber seal, under the leakproof cassette rubber seal
Surface formation one is enclosed on the groove for being connected to the casing edge, the opposite side side wall of the casing and opens up installation respectively
Hole, the body portion of meander shape medical stainless steel pipe is laid in the casing, the two ends of the meander shape medical stainless steel pipe respectively by
The two described mounting holes stretch out, and the meander shape also installed in leakproof rubber seal, the casing at the mounting hole is medical
The lower section of stainless steel tube install installed on diving water circulating pump and heating heating wire, the lateral wall of the casing temperature display,
Power switch and power supply indicator；
The donor self-blood collection device includes the first female Luer, the first medical the PV pipes and blood being sequentially connected
Pond, the blood pool is additionally provided with the first inlet, the first outlet, the second outlet and the 3rd outlet；
The first of the first outlet connection mutual anti-phase beating pump of pull of the blood pool flows into end, and the mutual pull is anti-phase
First outflow end of beating pump connects the inflow end of the oxygenator, and the outflow end of the oxygenator connects the isolated organ and protected
One end of meander shape medical stainless steel pipe warm, in blood warming equipment, the other end connection of the meander shape medical stainless steel pipe
Second medical PV pipes and the second female Luer, the oxygenator connect apparatus of oxygen supply；
The second of the second outlet connection mutual anti-phase beating pump of pull of the blood pool flows into end, and the mutual pull is anti-phase
Second outflow end of beating pump connects the inflow end of the filter, and the outflow end of the filter is respectively communicated with waste fluid bag and threeway；
3rd outlet of the blood pool connects the inflow end of the first roller list pump, and the outflow end of the first roller list pump connects
It is connected in the threeway communicated with the filter；
The urine collecting includes the 3rd female Luer, the 3rd medical the PV pipes and urine collecting bag being sequentially connected；
The bile collection device includes the 4th female Luer, the 4th medical the PV pipes and biliary drainage bag being sequentially connected.
Preferably, described oxygenator is membrane oxygenator.
Preferably, the second roller list pump is installed between described filter and waste fluid bag.
Preferably, swelled upwards centered on transparent heat-insulation lid in the insulation of described isolated organ, blood warming equipment
Arcuate in shape.
Preferably, two mounting holes opened up in the insulation of described isolated organ, blood warming equipment on casing are in tiltedly right
Angle position is laid on the casing, and the two mounting hole sites are in same horizontal line.
The alleged anti-phase beating pump of mutually pull can be untouchable electromagnetic coupled cylinder type liquid pumping system, institute in the present invention
State untouchable electromagnetic coupled cylinder type liquid pumping system and be disclosed in Application No. " 201410081699.9 ", Authorization Notice No. and be
" in CN 103845766B ", the patent of invention of entitled " untouchable electromagnetic coupled cylinder type liquid pumping system " or
Blood pump, the Blood pump structure be disclosed in Application No. " 201210352055.X ", Authorization Notice No. for " CN 102886082B ",
The patent of invention of entitled " active in-vitro lung auxiliary system ".
The invention also provides a kind of isolated organ (liver kidney joint) acquisition methods：
Open diaphragm pin, exposure abdominal aorta and part aorta pectoralis.
1st, the ramus splanchnicus in abdominal aorta：It is disconnected to prick inferior phrenic artery, middle suprarenal artery, superior mesenteric artery, testis (ovary)
Artery.2nd, the wall branch in abdominal aorta：It is disconnected to prick T12 thorax arteries, L1 lumbar arteries.
3rd, coeliac trunk：It is disconnected to prick arteria linenalis, left gastric artery.
4th, below horizontal from T11 thorax arteries mouthful, the horizontal flat above dialysis sustainer of saliva of L2 lumbar arteries mouthful, same level dialysis is upper and lower
Vena cave.
5th, break and prick cystic artery, cut off gall-bladder, distal common bile duct dialysis.
6th, portal vein lower end dialysis.
7th, dissociate bilateral ureteral, at the dialysis of ureter stage casing (testis/arteria ovarica level).
8th, break and prick arteria suprarenalis, adrenalectomize.
The isolated organ got using the above method is stored in the isolated organ insulation, blood warming equipment,
Specific implementation method is：
1st, sterile distilled water is first injected in casing, medical silica-gel film is submerged water pocket is formed in distilled water；
2nd, switch on power, turn on the power switch, the prompting of power supply indicator bright light, now dive under water water circulating pump and heating electric heating
Silk work.
3rd, heating heating wire is by blood outlet temperature inductor feedback control, and observed temperature is shown in the lateral wall of casing
Temperature display on.
4th, isolated organ covers opening on transparent heat-insulation lid, various pipeline self-induced transparency insulation covers after being placed on medical silica-gel film
Draw in hole.
5th, cover transparent heat-insulation lid and be incubated observation.
Leakproof cassette rubber seal, medical silica-gel film and meander in the isolated organ insulation, blood warming equipment
Shape medical stainless steel pipe is the disposable consumption product of jettisonable.Remaining component is fixture, can Reusability.It is described to protect
Reusability after warm lid erasable sterilization.
The invention also provides a kind of a kind of in vitro liver, kidney joint preservation that system is preserved using above-mentioned isolated organ
Implementation, comprise the following steps：
Isolated organ described in step a. preserves the system output of system and input is made short circuit and is connected, with the blood pool phase
Logical female Luer opens exhaust；
Step b. is rushed in advance：1000ml physiological saline+2ml heparin is injected into blood pool, open Rule communicated with the blood pool
Joint and the first inlet, start the anti-phase beating pump of mutual pull and the first roller list pump, carry out 30min self-loopa, abundant liver
Gas in elementization, and discharge line, starts isolated organ insulation, blood warming equipment and reaches design temperature；
Step c1. collects the whole blood of donor, and wherein 2000ml blood is medical by the first female Luer and first
PV pipes inject blood pool, while injecting anticoagulant heparin, remaining blood sodium citrate anti-freezing is refrigerated standby；
First outlet of step c2. blood pools is connected with the first inflow end of the anti-phase beating pump of mutual pull with medical PV pipes；
First outflow end of the anti-phase beating pump of the mutual pull of step c3. and the inflow end of oxygenator are connected with medical PV pipes；
Meander shape in the outflow end of step c4. oxygenators and isolated organ insulation, blood warming equipment is medical not
One end of rust steel pipe is connected with medical PV pipes；
Isolated organ is placed in isolated organ insulation, on the medical silica-gel film of blood warming equipment by step c5.；
The other end of meander shape medical stainless steel pipe described in step c6. is with the second medical PV pipes and the second female Luer and abdomen
Aortic stumps (near, distal end) are connected, the other end closing of abdominal aorta stump；
Second inflow end of the second outlet of step c7. blood pools and the mutual anti-phase beating pump of pull is connected with medical PV pipes
Connect；
Second outflow end of the anti-phase beating pump of the mutual pull of step c8. is connected with the inflow end of the filter with medical PV pipes；
The outflow end of step c9. filters is respectively communicated with waste fluid bag and threeway, and the threeway can also be breeches joint connection；
3rd outlet of step c10. blood pools is connected with the first roller list pump with medical PV pipes；
The outflow end of step c11. the first roller list pumps is connected in the threeway (or breeches joint) communicated with the filter；
Threeway (or breeches joint) remittance abroad described in step c12. mouthful is connected with medical PV pipes and female Luer with portal vein stump
Connect；
Step c13. vena caves stump (proximal part) is sequentially connected the first female Luer and the first medical PV pipes connect with blood pool
Connect, vena cave distal end is pricked and closed；
Step c14. choledochus stumps are sequentially connected the 4th female Luer, the 4th medical PV pipes and biliary drainage bag；
Step c15. double ureter stumps are sequentially connected the 3rd female Luer, the 3rd medical PV pipes and urine collecting bag；
Step c16. oxygenators connect apparatus of oxygen supply；
Install the second roller list pump (P4) between step c17. filters and waste fluid bag additional when necessary；
After step c18. connections are finished, it is vented with the high-end position of syringe needle；
Step d1. is run：Open the pump speed 500-2000ml/H of two blood pumps (P1 and P2) in the anti-phase beating pump of mutual pull；
Oxygenator passes through apparatus of oxygen supply oxygen supply, flow 0.5-2L/min；
Between isolated organ insulation, 36-38 DEG C of the temperature control of blood warming equipment；
First roller list pump (P3) pump speed 200-350mol/min is opened, bile, urine, waste liquid, unit interval meter is collected
Amount, directly adds medicine, electrolyte, displacement liquid in the first inlet injection end of blood pool as needed.
Managed in step d2. operations：To including composition, anti-freezing, oxygen confession, amount of liquid ring in blood temperature, pump speed, blood in operation
Section is managed；
Step d21. blood temperature：Control is between 36-38 DEG C, main adjustment electric-heating-wire-heating desired value；
Step d22. blood pumps：Speed control is adjusted in the range of 500-2000ml/min according to bile and secretion of urine amount
Mutual anti-phase beating pump (2) P1 and P2 of pull pump speed；
Step d23. blood constituents：Periodic monitor includes blood routine, blood glucose, liver function, renal function, electrolyte, C reaction eggs
In vain, corresponding medicine is directly added in blood pool according to measurement result, including：Antibiotic, outstanding red, blood plasma, human serum albumin, pancreas
Island element, electrolyte, sugar, amino acid, Fat Emulsion, sodium acid carbonate；
Step d24. anti-freezings：The whole blood clotting time (ACT) of periodic monitor activation, adds heparin, ACT controls in blood pool
Target is in 250s or so；
Step d25. oxygen is supplied：Oxygenator port of export blood sampling periodic monitor vim and vigour, oxygen flow is adjusted according to Results of Blood-gas；
Step d26. liquid：According to packed cell volume, hemoglobin, indicators in bile, urine and waste liquid amount, blood routine,
Displacement liquid, blood plasma, physiological saline, glucose solution are added in blood pool.
The beneficial effects of the invention are as follows using continuous pulsation pump as circulation power, promote donor self-blood, through membrane type
Oxygen is closed, and isolated organ persistently obtains oxygen and supplied and nutrient, while cell metabolite can be discharged through natural pipeline, if necessary can be through blood
Filtering device is purified.Farthest ensure that isolated organ is in a biomimetic environment, preferably maintains cell
Microenvironment is to ensure that its function is normal.With isolated organ blood secretion in the present invention, the material of useless (residual) thing contact is followed
Can disposably abandon, nontoxic sterile principle.Pass through the real-time prison of pressure flow, bubble, secretion and useless (residual) liquid in the present invention
Survey, assess the preservation quality of isolated organ, the present invention achievable liver, kidney are respectively with preserving simultaneously.
The present invention is the anti-phase beating pump of mutual pull based on a kind of new blood pump, integrates membrane oxygenator, filter, roller list pump
With necessary monitoring inductor, propose a kind of biomimetic store method of isolated organ using donor self-blood and preserve system
System.For the acquisition methods and insulating heating device of this isolated organ matched especially set out.Purpose is to greatest extent
Extend the holding time of isolated organ (liver, kidney), be readily transported, repair, improve transplanting success rate and the survival rate of acceptor.
The characteristics of present invention is using new blood pump, has fully taken into account the physiology of liver systemic circulatory system and portal system independence
Characteristic, establishes body circulation and portal circulation two systems, closest physiological status.
Isolated organ insulation proposed by the present invention, the existing insulation heating function of blood warming equipment, while again as one
Observation, operation, protecting platform.The component contacted with organ is deserted disposable.Simple in construction, easy for installation, peace
It is complete reliable.
In running and management proposed by the present invention, blood pool is both collected as blood back, is blood output source again, can pass through note
Hole adds medicine, water, electrolyte, displacement liquid to blood pool, simple and convenient.Make it possible the in vitro reparation of marginal organ.
The acquisition methods of isolated organ proposed by the present invention and system connection method, have farthest saved organ blood vessel from damage
Branch loop, facilitates the interception of the donor organ blood vessel in transfer operation, facilitates vascular anastomosis.
The equally applicable liver of the present invention, kidney are individually preserved.Matching the second roller list pump (P4) can be only in acute renal failure or liver
Play a part of blood purification during vertical preservation.
Brief description of the drawings
Fig. 1 is structural representation of the invention；
Fig. 2 is isolated organ insulation, the structural representation of blood warming equipment in the present invention；
Fig. 3 is the top view of casing；
Fig. 4 is the front view of casing.
Wherein：
Anti-phase beating pump 3- the first roller list pumps of the mutual pull of 1- blood pools 2-
The insulation of 4- oxygenator 5- isolated organs, blood warming equipment 6- apparatuss of oxygen supply
7- filter 8- waste fluid bag 9- urine collecting bags
10- biliary drainages bag 11- the second roller list pump 51- transparent heat-insulation lids
52- leakproof cassette rubber seal 53- medical silica-gel film 54- casings
56- diving water circulating pump 57- heating heating wire 58- meander shape medical stainless steel pipes
59- leakproof rubber seal 510- temperature display 511- perforates
512- power switches
Embodiment
Below in conjunction with the drawings and specific embodiments, the present invention will be further described.
Embodiment 1：
A kind of isolated organ as shown in Figure 1 to 4 preserves system, including donor self-blood collection device, mutual pull
It is anti-phase beating pump 2, the first roller list pump 3, oxygenator 4, isolated organ insulation, blood warming equipment 5, apparatus of oxygen supply 6, filter 7,
Waste fluid bag 8, urine collecting and bile collection device, wherein：
The isolated organ insulation, blood warming equipment 5 include transparent heat-insulation lid 51, medical silica-gel film 53 and casing 54, its
In：
Some perforates 511 are opened up on the transparent heat-insulation lid 51, the cover edge of the transparent heat-insulation lid 51 installs leakproof card
Formula rubber seal 52, the medical silica-gel film 53 is located at the inner side of the leakproof cassette rubber seal 52, in the leakproof cassette
The groove for being connected to the edge of casing 54, the opposite side of the casing 54 are enclosed in the lower surface formation one of rubber seal 52
Mounting hole is opened up on the wall of side respectively, the body portion of meander shape medical stainless steel pipe 58 is laid in the casing 54, meander shape doctor
Stretched out respectively by the two described mounting holes with the two ends of stainless steel tube 58, leakproof rubber seal is also installed at the mounting hole
The lower section of meander shape medical stainless steel pipe 58 in circle 59, the casing 54 is installed by diving water circulating pump 56 and heating heating wire
57, temperature display 510, power switch 511 and power supply indicator 512 are installed on the lateral wall of the casing 54；
The donor self-blood collection device includes the first female Luer, the first medical the PV pipes and blood being sequentially connected
Pond 1, the blood pool 1 is additionally provided with the first inlet, the first outlet, the second outlet and the 3rd outlet；
The first of the first outlet connection mutual anti-phase beating pump 2 of pull of the blood pool 1 flows into end, and the mutual pull is anti-
Mutually the first outflow end of beating pump 2 connects the inflow end of the oxygenator 4, and the outflow end of the oxygenator 4 connects the in vitro device
Official's insulation, one end of meander shape medical stainless steel pipe 58 in blood warming equipment 5, the meander shape medical stainless steel pipe 58 it is another
The medical PV pipes of one end connection second and the second female Luer, the oxygenator connect apparatus of oxygen supply 6；
The second of the second outlet connection mutual anti-phase beating pump 2 of pull of the blood pool 1 flows into end, and the mutual pull is anti-
Mutually the second outflow end of beating pump 2 connects the inflow end of the filter 7, and the outflow end of the filter 7 is respectively communicated with waste fluid bag 8 and three
It is logical；
3rd outlet of the blood pool 1 connects the inflow end of the first roller list pump 3, the outflow of the first roller list pump 3
End is connected in the threeway communicated with the filter 7；
The urine collecting includes the 3rd female Luer, the 3rd medical the PV pipes and urine collecting bag 9 being sequentially connected；
The bile collection device includes the 4th female Luer, the 4th medical the PV pipes and biliary drainage bag being sequentially connected
10。
Described oxygenator is membrane oxygenator.
Second roller list pump 11 is installed between described filter 7 and waste fluid bag 8.
The arch swelled upwards centered on transparent heat-insulation lid 51 in described isolated organ insulation, blood warming equipment 5
Shape.
Two mounting holes opened up in described isolated organ insulation, blood warming equipment 5 on casing 54 are in diagonally opposing corner position
It is laid on the casing 5, the two mounting hole sites are in same horizontal line.
Clinical practice example：
It is a kind of to utilize the implementation that above-mentioned isolated organ preserves a kind of in vitro liver of system, kidney joint is preserved, bag
Include following steps：
Isolated organ described in step a. preserves the system output of system and input is made short circuit and is connected, with the blood pool 1
The female Luer communicated opens exhaust；
Step b. is rushed in advance：1000ml physiological saline+2ml heparin is injected into blood pool 1, the open Shandong communicated with the blood pool 1
That joint and the first inlet, start the anti-phase beating roller list pump 3 of pump 2 and first of mutual pull, carry out 30min self-loopa, fill
Divide gas in test tube of hepari, and discharge line, start isolated organ insulation, blood warming equipment 5 and reach design temperature；
Step c1. collects the whole blood of donor, and wherein 2000ml blood is medical by the first female Luer and first
PV pipes inject blood pool, while injecting anticoagulant heparin, remaining blood sodium citrate anti-freezing is refrigerated standby；
First inflow end of the first outlet of step c2. blood pools 1 and the anti-phase beating pump 2 of mutual pull is connected with medical PV pipes
Connect；
First outflow end of the anti-phase beating pump 2 of the mutual pull of step c3. is connected with the inflow end of oxygenator 4 with medical PV pipes；
The outflow end of step c4. oxygenators 4 is incubated with the isolated organ, the meander shape in blood warming equipment 5 is medical
One end of stainless steel tube 58 is connected with medical PV pipes；
Isolated organ is placed in isolated organ insulation, on the medical silica-gel film 53 of blood warming equipment 5 by step c5.；
The other end of meander shape medical stainless steel pipe 58 described in step c6. with the second medical PV pipe and the second female Luer with
Abdominal aorta stump is connected, the other end closing of abdominal aorta stump；
Managed with medical PV at second inflow end of the second outlet of step c7. blood pools 1 and the mutual anti-phase beating pump 2 of pull
Connection；
The inflow end of the second outflow end and the filter 7 of the anti-phase beating pump 2 of the mutual pull of step c8. is connected with medical PV pipes
Connect；
The outflow end of step c9. filters 7 is respectively communicated with waste fluid bag and threeway；
3rd outlet of step c10. blood pools 1 is connected with the first roller list pump 3 with medical PV pipes；
The outflow end of step c11. the first roller lists pump 3 is connected in the threeway communicated with the filter 7；
Threeway remittance abroad described in step c12. mouthful is connected with medical PV pipes and female Luer with portal vein stump；
Step c13. vena cave stumps are sequentially connected the first female Luer and the first medical PV pipes are connected with blood pool, vena cave
Distal end is pricked and closed；
Step c14. choledochus stumps are sequentially connected the 4th female Luer, the 4th medical PV pipes and biliary drainage bag 10；
Step c15. double ureter stumps are sequentially connected the 3rd female Luer, the 3rd medical PV pipes and urine collecting bag 9；
Step c16. oxygenators 4 connect apparatus of oxygen supply 6；
Install the second roller list pump 11 (P4) between step c17. filters 7 and waste fluid bag 8 additional；
After step c18. connections are finished, it is vented with the high-end position of syringe needle；
Step d1. is run：Open the pump speed 500-2000ml/H of two blood pumps in the anti-phase beating pump of mutual pull；
Oxygenator 4 passes through the oxygen supply of apparatus of oxygen supply 6, flow 0.5-2L/min；
Between isolated organ insulation, 36-38 DEG C of the temperature control of blood warming equipment 5；
The pump speed 200-350mol/min of the first roller list pump 3 is opened, bile, urine, waste liquid is collected, the unit interval measures,
Medicine, electrolyte, displacement liquid are added in the first inlet injection end of blood pool 1；
Managed in step d2. operations：To including composition, anti-freezing, oxygen confession, amount of liquid ring in blood temperature, pump speed, blood in operation
Section is managed；
Step d21. blood temperature：Control is between 36-38 DEG C, main adjustment electric-heating-wire-heating desired value；
Step d22. blood pumps：Speed control is adjusted in the range of 500-2000ml/min according to bile and secretion of urine amount
The pump speed of the mutual anti-phase beating pump 2 of pull；
Step d23. blood constituents：Periodic monitor includes blood routine, blood glucose, liver function, renal function, electrolyte, C reaction eggs
In vain, corresponding medicine is directly added in blood pool according to measurement result, including：Antibiotic, outstanding red, blood plasma, human serum albumin, pancreas
Island element, electrolyte, sugar, amino acid, Fat Emulsion, sodium acid carbonate；
Step d24. anti-freezings：The whole blood clotting time (ACT) of periodic monitor activation, adds heparin, ACT controls in blood pool
Target is in 250s or so；
Step d25. oxygen is supplied：Oxygenator port of export blood sampling periodic monitor vim and vigour, oxygen flow is adjusted according to Results of Blood-gas；
Step d26. liquid：According to packed cell volume, hemoglobin, indicators in bile, urine and waste liquid amount, blood routine,
Displacement liquid, blood plasma, physiological saline, glucose solution are added in blood pool.
The preferred embodiment to the invention is illustrated above, but the invention be not limited to it is described
Embodiment, those skilled in the art can also make a variety of etc. on the premise of without prejudice to the invention spirit
Same modification or replacement, these equivalent modifications or replacement are all contained in the application claim limited range.
Claims (6)
1. a kind of isolated organ preserves system, it is characterised in that including donor self-blood collection device, the anti-phase beating of mutual pull
Pump (2), the first roller list pump (3), oxygenator (4), isolated organ insulation, blood warming equipment (5), apparatus of oxygen supply (6), filter
(7), waste fluid bag (8), urine collecting and bile collection device, wherein：
The isolated organ insulation, blood warming equipment (5) include transparent heat-insulation lid (51), medical silica-gel film (53) and casing
(54), wherein：
Some perforates (511) are opened up on the transparent heat-insulation lid (51), the cover edge of the transparent heat-insulation lid (51) installs leakproof
Cassette rubber seal (52), the medical silica-gel film (53) is located at the inner side of the leakproof cassette rubber seal (52), at this
The groove for being connected to the casing (54) edge, the case are enclosed in the lower surface formation one of leakproof cassette rubber seal (52)
Mounting hole is opened up on the opposite side side wall of body (54) respectively, the body portion of meander shape medical stainless steel pipe (58) is laid on the casing
(54) in, the two ends of the meander shape medical stainless steel pipe (58) are stretched out by the two described mounting holes respectively, the mounting hole
Install latent in the lower section that the meander shape medical stainless steel pipe (58) in leakproof rubber seal (59), the casing (54) is also installed at place
Temperature display (510), power supply are installed on water circulation water pump (56) and heating heating wire (57), the lateral wall of the casing (54)
Switch (511) and power supply indicator (512)；
The donor self-blood collection device includes the first female Luer, the first medical PV pipes and the blood pool being sequentially connected
(1), the blood pool (1) is additionally provided with the first inlet, the first outlet, the second outlet and the 3rd outlet；
The first of the first outlet connection mutual anti-phase beating pump (2) of pull of the blood pool (1) flows into end, and the mutual pull is anti-
Mutually the first outflow end of beating pump (2) connects the inflow end of the oxygenator (4), and the outflow end connection of the oxygenator (4) is described
Isolated organ insulation, one end of meander shape medical stainless steel pipe (58) in blood warming equipment (5), the meander shape are medical stainless
The medical PV pipes of other end connection second of steel pipe (58) and the second female Luer, the oxygenator connection apparatus of oxygen supply (6)；
The second of the second outlet connection mutual anti-phase beating pump (2) of pull of the blood pool (1) flows into end, and the mutual pull is anti-
Mutually the second outflow end of beating pump (2) connects the inflow end of the filter (7), and the outflow end of the filter (7) is respectively communicated with waste liquid
Bag (8) and threeway；
3rd outlet of the blood pool (1) connects the inflow end of the first roller list pump (3), the stream of the first roller list pump (3)
Go out end to be connected in the threeway communicated with the filter (7)；
The urine collecting includes the 3rd female Luer, the 3rd medical the PV pipes and urine collecting bag (9) being sequentially connected；
The bile collection device includes the 4th female Luer, the 4th medical the PV pipes and biliary drainage bag (10) being sequentially connected.
2. isolated organ according to claim 1 preserves system, it is characterised in that described oxygenator is membrane oxygenation
Device.
3. isolated organ according to claim 1 preserves system, it is characterised in that described filter (7) and waste fluid bag (8)
Between the second roller list pump (11) is installed.
4. isolated organ according to claim 1 preserves system, it is characterised in that described isolated organ is incubated, blood
The arcuate in shape swelled upwards centered on transparent heat-insulation lid (51) in heating apparatus (5).
5. isolated organ according to claim 1 preserves system, it is characterised in that described isolated organ is incubated, blood
Two mounting holes opened up in heating apparatus (5) on casing (54) are laid on the casing (5) in diagonally opposing corner position, the two installations
Hole position is in same horizontal line.
6. the implementation that a kind of in vitro liver, kidney joint are preserved, it is characterised in that using such as any institute of claim 1 to 5
The isolated organ stated preserves system, comprises the following steps：
Isolated organ described in step a. preserves the system output of system and input is made short circuit and is connected, with the blood pool (1) phase
Logical female Luer opens exhaust；
Step b. is rushed in advance：By 1000ml physiological saline+2ml heparin injection blood pool (1), the open Shandong communicated with the blood pool (1)
That joint and the first inlet, start the anti-phase beating pump (2) of mutual pull and the first roller list pump (3), carry out following certainly for 30min
Ring, abundant test tube of hepari, and gas in discharge line, start isolated organ insulation, blood warming equipment (5) and reach design temperature；
Step c1. collects the whole blood of donor, and wherein 2000ml blood is managed by the first female Luer and the first medical PV
Blood pool is injected, while injecting anticoagulant heparin, remaining blood sodium citrate anti-freezing is refrigerated standby；
First outlet of step c2. blood pools (1) and the first inflow end of the anti-phase beating pump (2) of mutual pull are connected with medical PV pipes
Connect；
First outflow end of the anti-phase beating pump (2) of the mutual pull of step c3. is connected with the inflow end of oxygenator (4) with medical PV pipes；
The outflow end of step c4. oxygenators (4) is incubated with the isolated organ, the meander shape in blood warming equipment (5) is medical
One end of stainless steel tube (58) is connected with medical PV pipes；
Isolated organ is placed in isolated organ insulation, on the medical silica-gel film (53) of blood warming equipment (5) by step c5.；
The other end of meander shape medical stainless steel pipe (58) described in step c6. is with the second medical PV pipes and the second female Luer and abdomen
Aortic stumps are connected, the other end closing of abdominal aorta stump；
Second outlet of step c7. blood pools (1) and the second inflow end of the mutual anti-phase beating pump (2) of pull are managed with medical PV
Connection；
The inflow end of the second outflow end and the filter (7) of the anti-phase beating pump (2) of the mutual pull of step c8. is connected with medical PV pipes
Connect；
The outflow end of step c9. filters (7) is respectively communicated with waste fluid bag and threeway；
3rd outlet of step c10. blood pools (1) is connected with the first roller list pump (3) with medical PV pipes；
The outflow end of step c11. the first roller list pumps (3) is connected in the threeway communicated with the filter (7)；
Threeway remittance abroad described in step c12. mouthful is connected with medical PV pipes and female Luer with portal vein stump；
Step c13. vena cave stumps are sequentially connected the first female Luer and the first medical PV pipes are connected with blood pool, vena cave telecentricity
End bundle is closed；
Step c14. choledochus stumps are sequentially connected the 4th female Luer, the 4th medical PV pipes and biliary drainage bag (10)；
Step c15. double ureter stumps are sequentially connected the 3rd female Luer, the 3rd medical PV pipes and urine collecting bag (9)；
Step c16. oxygenators (4) connection apparatus of oxygen supply (6)；
Install the second roller list pump (11) (P4) between step c17. filters (7) and waste fluid bag (8) additional；
After step c18. connections are finished, it is vented with the high-end position of syringe needle；
Step d1. is run：Open the pump speed 500-2000ml/H of two blood pumps in the anti-phase beating pump of mutual pull；
Oxygenator (4) passes through apparatus of oxygen supply (6) oxygen supply, flow 0.5-2L/min；
Between isolated organ insulation, 36-38 DEG C of the temperature control of blood warming equipment (5)；
First roller list pump (3) pump speed 200-350mol/min is opened, bile, urine, waste liquid is collected, the unit interval measures,
First inlet injection end of blood pool (1) adds medicine, electrolyte, displacement liquid；
Managed in step d2. operations：To entering including composition, anti-freezing, oxygen confession, amount of liquid link in blood temperature, pump speed, blood in operation
Row management；
Step d21. blood temperature：Control is between 36-38 DEG C, main adjustment electric-heating-wire-heating desired value；
Step d22. blood pumps：Speed control is mutually drawn in the range of 500-2000ml/min according to bile with the adjustment of secretion of urine amount
The pump speed of the anti-phase beating pump (2) of formula；
Step d23. blood constituents：Periodic monitor includes blood routine, blood glucose, liver function, renal function, electrolyte, c reactive protein,
Corresponding medicine is directly added in blood pool according to measurement result, including：Antibiotic, outstanding red, blood plasma, human serum albumin, pancreas islet
Element, electrolyte, sugar, amino acid, Fat Emulsion, sodium acid carbonate；
Step d24. anti-freezings：The whole blood clotting time (ACT) of periodic monitor activation, adds heparin, ACT control targes in blood pool
In 250s or so；
Step d25. oxygen is supplied：Oxygenator port of export blood sampling periodic monitor vim and vigour, oxygen flow is adjusted according to Results of Blood-gas；
Step d26. liquid：According to packed cell volume, hemoglobin, indicators in bile, urine and waste liquid amount, blood routine, in blood pool
Middle addition displacement liquid, blood plasma, physiological saline, glucose solution.
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| WO2021036738A1 (en) * | 2019-08-26 | 2021-03-04 | 广东顺德工业设计研究院(广东顺德创新设计研究院) | Ex vivo organ perfusion container |
| CN111165471A (en) * | 2020-03-23 | 2020-05-19 | 郑州大学第一附属医院 | Normal temperature low pressure normal oxygen liver perfusion system |
| CN116369310A (en) * | 2023-06-02 | 2023-07-04 | 中山大学附属第一医院 | Portable uninterrupted blood flow organ perfusion device and use method thereof |
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