Karaciğer Kanseri ve Makine Perfüzyonu: Yeni Nesil Nakil Stratejileri

Öz

Dünya genelinde karaciğer nakli sayısı her geçen yıl artmakta ve uygun donör organ bulma konusundaki yetersizlik de aynı oranda devam etmektedir. Özellikle son yıllarda obezite ve karaciğer yağlanması vakalarının ciddi artışı dünya genelinde donör kalitesini düşürmekte; sağlıklı donör bulmak günden güne zorlaşmaktadır. Artan talep karşısında, marjinal donör karaciğerlerinin kullanımı yaygınlaşmaktadır. Ancak bu greftler, genellikle iskemik hasara daha yatkın olup, nakil sonrası primer disfonksiyon, erken greft yetmezliği ve safra yolu komplikasyonları gibi ciddi sorunlarla ilişkilendirilmektedir. Bu olumsuzlukları önlemek amacıyla geliştirilen makine perfüzyon (MP) teknolojisi, greftlerin daha fizyolojik koşullarda korunmasını sağlayarak iskemik hasarı azaltmayı ve organın nakil öncesi fonksiyonel durumunu değerlendirmeyi mümkün kılmaktadır. Böylece, özellikle marjinal greftlerin güvenli kullanımını desteklemekte ve nakil başarısını artırma potansiyeli taşımaktadır. Bu derleme, MP teknolojisinin prensiplerini, karaciğer naklindeki mevcut ve potansiyel kullanım alanlarını ele almakta; ayrıca bu teknolojinin gelecekteki uygulamalarına dair yenilikçi yaklaşımları incelemektedir.

Anahtar Kelimeler

• Makine perfüzyonu
• marjinal donör
• karaciğer nakli

Liver cancer and machine perfusion: Next generation transplant strategies

Öz

The number of liver transplants worldwide continues to increase each year, while the shortage of suitable donor organs persists at a similar rate. In recent years, the dramatic rise in obesity and liver steatosis cases has further reduced donor quality globally, making it increasingly difficult to find healthy donors. In response to growing demand, the use of marginal donor livers has become more common. However, these grafts are generally more susceptible to ischemic injury and are associated with serious complications such as primary graft dysfunction, early graft failure, and biliary complications following transplantation. To mitigate these adverse outcomes, machine perfusion (MP) technology has been developed to preserve grafts under more physiological conditions, thereby reducing ischemic injury and enabling assessment of organ function prior to transplantation. This approach particularly supports the safer use of marginal grafts and holds the potential to improve transplant success rates. This review discusses the principles of MP technology, its current and potential applications in liver transplantation, and explores innovative approaches for its future implementation.

Anahtar Kelimeler

• machine perfusion
• marginal donor
• liver transplantation

Kaynakça

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