CN109619091B - Kidney perfusion device - Google Patents
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- 230000010412 perfusion Effects 0.000 title claims abstract description 146
- 210000003734 kidney Anatomy 0.000 title claims abstract description 90
- 239000008280 blood Substances 0.000 claims abstract description 109
- 210000004369 blood Anatomy 0.000 claims abstract description 109
- 210000002254 renal artery Anatomy 0.000 claims abstract description 59
- 230000004087 circulation Effects 0.000 claims abstract description 50
- 210000003462 vein Anatomy 0.000 claims abstract description 36
- 210000001367 artery Anatomy 0.000 claims abstract description 33
- 230000008081 blood perfusion Effects 0.000 claims abstract description 27
- 239000007788 liquid Substances 0.000 claims abstract description 23
- 210000000056 organ Anatomy 0.000 claims description 49
- 238000012544 monitoring process Methods 0.000 claims description 26
- 210000002796 renal vein Anatomy 0.000 claims description 21
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 claims description 17
- 229910052760 oxygen Inorganic materials 0.000 claims description 17
- 239000001301 oxygen Substances 0.000 claims description 17
- 210000002700 urine Anatomy 0.000 claims description 17
- 238000004555 blood preservation Methods 0.000 claims description 15
- 239000002207 metabolite Substances 0.000 claims description 15
- 230000004872 arterial blood pressure Effects 0.000 claims description 14
- 235000015097 nutrients Nutrition 0.000 claims description 7
- 230000008321 arterial blood flow Effects 0.000 claims description 6
- 230000017531 blood circulation Effects 0.000 claims description 6
- 239000000126 substance Substances 0.000 claims description 6
- 238000004891 communication Methods 0.000 claims description 5
- 239000000945 filler Substances 0.000 claims description 5
- 238000001914 filtration Methods 0.000 claims description 5
- 230000036772 blood pressure Effects 0.000 claims description 4
- 210000004204 blood vessel Anatomy 0.000 claims description 3
- 239000013589 supplement Substances 0.000 claims description 3
- 230000001502 supplementing effect Effects 0.000 claims description 3
- 235000008708 Morus alba Nutrition 0.000 claims description 2
- 240000000249 Morus alba Species 0.000 claims description 2
- 230000001706 oxygenating effect Effects 0.000 claims description 2
- 238000007789 sealing Methods 0.000 claims 1
- 239000012530 fluid Substances 0.000 abstract description 16
- 230000006378 damage Effects 0.000 abstract description 10
- 238000004321 preservation Methods 0.000 abstract description 7
- 238000000034 method Methods 0.000 description 21
- 230000006870 function Effects 0.000 description 8
- 208000028867 ischemia Diseases 0.000 description 8
- 238000001727 in vivo Methods 0.000 description 7
- 206010021143 Hypoxia Diseases 0.000 description 5
- 238000001802 infusion Methods 0.000 description 5
- 230000008569 process Effects 0.000 description 5
- 230000008859 change Effects 0.000 description 4
- 238000005516 engineering process Methods 0.000 description 4
- 238000011156 evaluation Methods 0.000 description 4
- 230000007954 hypoxia Effects 0.000 description 4
- 238000012546 transfer Methods 0.000 description 4
- 238000007710 freezing Methods 0.000 description 3
- 230000008014 freezing Effects 0.000 description 3
- 230000002572 peristaltic effect Effects 0.000 description 3
- 208000021709 Delayed Graft Function Diseases 0.000 description 2
- 208000007536 Thrombosis Diseases 0.000 description 2
- 230000009471 action Effects 0.000 description 2
- 238000001514 detection method Methods 0.000 description 2
- 230000002806 hypometabolic effect Effects 0.000 description 2
- 238000000338 in vitro Methods 0.000 description 2
- 230000003907 kidney function Effects 0.000 description 2
- 238000006213 oxygenation reaction Methods 0.000 description 2
- 230000002980 postoperative effect Effects 0.000 description 2
- 238000011084 recovery Methods 0.000 description 2
- 230000008439 repair process Effects 0.000 description 2
- 238000000926 separation method Methods 0.000 description 2
- 210000005239 tubule Anatomy 0.000 description 2
- 230000008320 venous blood flow Effects 0.000 description 2
- 206010049993 Cardiac death Diseases 0.000 description 1
- 206010011906 Death Diseases 0.000 description 1
- 206010021113 Hypothermia Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 208000020832 chronic kidney disease Diseases 0.000 description 1
- 238000011109 contamination Methods 0.000 description 1
- 239000002826 coolant Substances 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 208000028208 end stage renal disease Diseases 0.000 description 1
- 201000000523 end stage renal failure Diseases 0.000 description 1
- 238000002474 experimental method Methods 0.000 description 1
- 210000003191 femoral vein Anatomy 0.000 description 1
- 230000002631 hypothermal effect Effects 0.000 description 1
- 230000001146 hypoxic effect Effects 0.000 description 1
- 239000012535 impurity Substances 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000004731 jugular vein Anatomy 0.000 description 1
- 208000017169 kidney disease Diseases 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
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- 235000016709 nutrition Nutrition 0.000 description 1
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- 239000000082 organ preservation Substances 0.000 description 1
- 238000002496 oximetry Methods 0.000 description 1
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- 230000010410 reperfusion Effects 0.000 description 1
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- 238000002054 transplantation Methods 0.000 description 1
Classifications
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- 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
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- Engineering & Computer Science (AREA)
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Abstract
The embodiment of the application discloses a kidney perfusion device, wherein a kidney vein circulation switching module is used for connecting a donor kidney vein with a vein connecting end of a normal-temperature perfusion module so as to drain venous blood of the donor kidney vein into the normal-temperature perfusion module; the renal artery circulation switching module is used for connecting the donor renal artery with the arterial connecting end of the normal-temperature perfusion module so as to drain the arterial blood output by the normal-temperature perfusion module back to the donor renal artery; the first filter, the first oxygenator and the first centrifugal pump are sequentially communicated through a first pipeline, the first filter is used for being communicated with a donor vein, and the first centrifugal pump is used for being communicated with a donor artery; the first liquid filling device is used for communicating with the donor artery and replenishing perfusate to the donor renal artery while the venous blood is drained by the renal venous circulation switching module; the normal temperature perfusion module is used for kidney perfusion. The embodiment of the application replaces cold perfusion preservation with blood perfusion, and prevents secondary damage caused by the refrigerating fluid, so that risks of PNF and DGF are reduced.
Description
Technical Field
The application relates to the technical field of medical equipment, in particular to a kidney perfusion device.
Background
Kidney organ transplant surgery is an effective means of treating end-stage kidney disease. Meanwhile, the number of kidney disease patients in China is numerous, and the demand for kidney sources is huge. From 1 month and 1 day of 2015, china starts to implement a citizen organ donation system, and the donor source of organs can only voluntarily donate through citizens of China. The domestic healthy organ donation rate is not high, and the clinical healthy organ is in short supply.
In case of a short supply of healthy organs, organ sources of other non-healthy donors are used clinically, such as heart-dead donor organs (Donation after cardiac death, DCD organs). However, since DCD organs undergo a period of thermal ischemia, the DCD organ itself has a certain damage condition.
At present, the DCD organ preservation method is as follows:
the DCD organ is firstly obtained from a donor, and then perfusion refrigerating fluid is carried out on the DCD organ for cold perfusion preservation, so that the kidney filled with the refrigerating fluid can enter an anoxic hypometabolic state. DCD organs after entering the hypoxic hypometabolic state will be stored in a low temperature environment for transport to hospitals. While hypothermia, hypoxia and ischemia can cause secondary damage to the DCD organ, resulting in increased risk of the DCD organ after transplantation to develop post-transplant Primary non-function (PNF) and delayed graft function recovery (delayed graft function, DGF), PNF and DGF can lead to risk of other post-operative transplant complications in the patient and increased cost and time of post-operative recovery.
Therefore, after the DCD organ reaches a hospital, the DCD organ is perfused by using an organ perfusion technology, so that the damage caused by the refrigerating fluid in the cold perfusion preservation process is reduced. Organ perfusion technology is to preserve organs by simulating the environment in human body, and its main components are oxygenator, peristaltic pump, heater, freezer and blood preservation bag. Organ perfusion provides perfusion power by simulating a heart through a peristaltic pump, the peristaltic pump replaces blood with a perfusion fluid taking blood as a substrate to perfuse the organ, and the perfusion fluid contains necessary nutrients required by the organ. At the same time, the perfusate will be supplied with oxygen through the oxygenator. Therefore, the organ perfusion technology reduces the hypoxia and ischemia injury caused by the freezing solution by providing nutrition, temperature and oxygen required by the organ; experiments prove that after the DCD organ is preserved by the refrigerating fluid, the risk of PNF and DGF can be reduced by reperfusion by an organ perfusion technology.
However, for DCD organs, the longer the ischemia and hypoxia time, the greater the risk of PNF and DGF, so that DCD organs undergo secondary damage by the freezing fluid after undergoing a period of thermal ischemia themselves, and although organ perfusion techniques can reduce hypoxia and ischemia damage by the freezing fluid, the risk of PNF and DGF is still greater.
Disclosure of Invention
The embodiment of the application provides a kidney perfusion device, and this application embodiment uses the experience blood to fill and replace cold perfusion to preserve, prevents the second time damage that the coolant caused to reduce the risk that PNF and DGF appear.
In view of the foregoing, embodiments of the present application provide a kidney perfusion device, comprising: the device comprises a perfusion support module, a normal temperature perfusion module, a renal vein circulation switching module and a renal artery circulation switching module;
the kidney vein circulation switching module is used for connecting a donor kidney vein with a vein connecting end of the normal-temperature perfusion module so as to drain venous blood of the donor kidney vein into the normal-temperature perfusion module;
the renal artery circulation switching module is used for connecting a donor renal artery with an artery connecting end of the normal-temperature perfusion module so as to lead arterial blood output by the normal-temperature perfusion module to flow back to the donor renal artery;
the perfusion support module comprises a first pipeline, a first filter, a first oxygenator, a first centrifugal pump and a first liquid filler;
the first filter, the first oxygenator and the first centrifugal pump are sequentially communicated through the first pipeline, the first filter is used for being communicated with a donor vein, and the first centrifugal pump is used for being communicated with a donor artery;
the first liquid filling device is used for being communicated with the donor artery, and replenishing perfusion liquid to the donor renal artery while the venous blood is drained by the renal venous circulation switching module;
the normal temperature perfusion module is used for kidney perfusion.
Preferably, the method comprises the steps of,
the perfusion support module further includes a first renal artery pressure control sub-module disposed on a first line between the first centrifugal pump and the donating artery.
Preferably, the method comprises the steps of,
the first renal artery pressure control submodule is further arranged on a first pipeline between the first liquid filling device and the donor artery.
Preferably, the method comprises the steps of,
the perfusion support module further includes a first bubble filter;
the first bubble filter is disposed on a first line between the first oxygenator and the first centrifugal pump or on a first line between the first centrifugal pump and the donating artery.
Preferably, the method comprises the steps of,
the perfusion support module also includes a first flow sensor disposed on a first line between the first centrifugal pump and the donating artery.
Preferably, the method comprises the steps of,
the normal temperature perfusion module comprises a second pipeline, an organ storage platform, a second filter, a second oxygenator, a second centrifugal pump, a second bubble filter, a temperature control submodule, a blood storage bag, a bubble monitor and an arterial blood perfusion pressure control submodule;
the organ storage platform is used for placing the isolated kidney and controlling the temperature of the kidney within a preset range;
the vein connecting end and the artery connecting end are respectively arranged on the organ storage platform;
the venous connection end, the second filter, the blood storage bag, the second oxygenator, the second centrifugal pump, the temperature control sub-module, the arterial blood perfusion pressure control sub-module and the arterial connection end are sequentially communicated through the second pipeline;
the second bubble filter and the bubble monitor are sequentially arranged on a pipeline between the second oxygenator and the temperature control submodule.
Preferably, the method comprises the steps of,
the normal temperature perfusion module further comprises a venous blood perfusion pressure control device, and the venous blood perfusion pressure control device is arranged on a pipeline between the second filter and the venous connection end.
Preferably, the method comprises the steps of,
the normal temperature perfusion module further comprises a second liquid adding device communicated with the blood preservation bag and used for supplementing nutrient substances for blood in the blood preservation bag.
Preferably, the method comprises the steps of,
the normothermic perfusion module further comprises a blood flow rate sensing sub-module arranged on a pipeline between the second centrifugal pump and the arterial blood perfusion pressure control sub-module.
Preferably, the method comprises the steps of,
the normal temperature perfusion module further comprises a metabolite monitoring submodule;
the metabolite monitoring submodule is arranged on a pipeline between the second centrifugal pump and the arterial blood perfusion pressure control submodule and/or on a pipeline between the second filter and the blood preservation bag.
Preferably, the method comprises the steps of,
the normal temperature perfusion module further comprises a blood oxygen monitoring sub-module;
the blood oxygen monitoring submodule is arranged on a pipeline between the second centrifugal pump and the arterial blood perfusion pressure control submodule and/or on a pipeline between the second filter and the blood preservation bag.
Preferably, the method comprises the steps of,
the normal temperature perfusion module also comprises a urine collector;
the organ storage platform mulberry is also provided with a urine collection pipeline;
the urine collector is communicated with the three-dimensional kidney through the urine collecting pipeline.
Preferably, the method comprises the steps of,
the normal temperature perfusion module further comprises a renal tubule function monitoring sub-module arranged on the urine collecting pipeline.
Preferably, the method comprises the steps of,
the kidney perfusion device also comprises an organ evaluation system connected with each working device, and the organ evaluation system is used for evaluating the kidney state according to the perfusion parameters of each working device.
From the above technical solutions, the embodiments of the present application have the following advantages:
in an embodiment of the present application, there is provided a kidney perfusion device including: the device comprises a perfusion support module, a normal temperature perfusion module, a renal vein circulation switching module and a renal artery circulation switching module; the perfusion support module comprises a first pipeline, a first filter, a first oxygenator, a first centrifugal pump and a first liquid filler; the first filter, the first oxygenator and the first centrifugal pump are sequentially communicated through a first pipeline, the first filter is communicated with a donor vein, venous blood can be obtained from the donor vein through the first filter, then the venous blood is filtered through the first filter, oxygenation is carried out through the first oxygenator, so that the venous blood becomes arterial blood, then the first centrifugal pump provides power to simulate heart pulse perfusion blood, the arterial blood is conveyed to a donor artery, the arterial blood flows to the kidney in a donor body, and therefore functions of blood, nutrients and the like for the kidney are provided for maintaining the kidney;
supplying blood to the kidney by filling the perfusion support module for a period of time; adopting a renal vein circulation switching module to drain venous blood of a donor renal vein into a normal-temperature perfusion module; simultaneously, replenishing perfusion fluid to the donor renal artery by using the first liquid charger to replenish lost blood and blood pressure; after the venous blood drainage is finished, closing other blood vessels except the renal artery, and draining the arterial blood output by the normal-temperature perfusion module back to the donor renal artery through the renal artery circulation switching module so as to finish the perfusion of the kidney;
therefore, the embodiment of the application firstly performs in-vivo perfusion through the perfusion support module, and then completely transfers the blood through the renal vein circulation switching module and the renal artery circulation switching module in the kidney separation process, cold perfusion preservation is not needed by perfusion of the refrigerating fluid, the ischemia time of the kidney is shortened, and meanwhile, secondary damage caused by the refrigerating fluid is prevented, so that the risk of PNF and DGF is reduced; finally, necessary substances and conditions required by kidney repair are provided through the normal temperature perfusion module, so that the kidney can quickly recover the original functions of the kidney and the quality of kidney organs is improved.
Drawings
Fig. 1 is a schematic structural view of an embodiment of a kidney perfusion device according to the present application.
Detailed Description
In order to make the present application solution better understood by those skilled in the art, the following description will clearly and completely describe the technical solution in the embodiments of the present application with reference to the accompanying drawings in the embodiments of the present application, and it is apparent that the described embodiments are only some embodiments of the present application, not all embodiments. All other embodiments, which can be made by one of ordinary skill in the art without undue burden from the present disclosure, are within the scope of the present disclosure.
Referring to fig. 1, a schematic diagram of an embodiment of a kidney perfusion apparatus is shown.
An embodiment of the present application provides a kidney perfusion device, including: the perfusion support module 100, the normal temperature perfusion module 200, the renal vein circulation switching module 7 and the renal artery circulation switching module 8.
The renal venous circulation switching module 7 is used for connecting the donor renal vein with the venous connection end 9 of the normothermic perfusion module 200 so as to drain venous blood of the donor renal vein into the normothermic perfusion module 200.
The renal artery circulation switching module 8 is used for connecting the donor renal artery with the arterial connection end 10 of the normothermic perfusion module 200 so as to drain arterial blood output by the normothermic perfusion module 200 back to the donor renal artery.
It should be noted that, in the embodiment of the present application, the kidney is perfused in vivo by the perfusion support module 100, and then transferred to the normal temperature perfusion module 200 for perfusion, and in the transfer process, the normal temperature perfusion module 200 is connected to the vein and the artery of the kidney by the renal venous circulation switching module 7 and the renal artery circulation switching module 8, respectively.
The perfusion support module 100 comprises a first line, a first filter 1, a first oxygenator 2, a first centrifugal pump 3 and a first liquid charger 6.
The first filter 1, the first oxygenator 2 and the first centrifugal pump 3 are in communication in sequence through a first pipeline, the first filter 1 being for communication with a donor vein, the first centrifugal pump 3 being for communication with a donor artery.
In the embodiment of the present application, one end of the venous cannula may be inserted into a human body to communicate with a vein of a donor, and the other end may communicate with the first filter 1; one end of the arterial cannula can be inserted into a human body to be communicated with the donor artery, and the other end of the arterial cannula is communicated with the first centrifugal pump 3; the donor vein may be the jugular vein of the donor or the femoral vein of the donor, and venous blood may be taken from the donor vein by the dynamic action of the first centrifugal pump 3 and the heart pulse perfusion blood may be simulated.
The first filter 1 is used for filtering blood clots and other foreign matters in venous blood, and the first oxygenator 2 is used for oxygenating the filtered venous blood, so that the venous blood becomes arterial blood, and the arterial blood flows into a donor artery through the action of a centrifugal pump.
It is understood that arterial blood entering the donating artery flows into the kidney to provide the kidney with nutrients, blood, and oxygen, etc., due to the internal circulatory system within the human body.
In addition, the first filter 1 is provided between the first oxygenator 2 and the donor artery in order to filter venous blood first, so as to prevent contamination of venous blood carrying foreign substances or devices such as the first oxygenator 2 after occlusion.
In the embodiment of the present application, the normothermic perfusion module 200 is used for kidney perfusion, and since the normothermic perfusion module 200 is an existing module, the embodiment of the present application is not described in detail herein.
The first liquid filler 6 is used for communicating with the donor artery, and replenishing the donor renal artery with perfusion liquid while the venous blood is drained by the renal venous circulation switching module 7.
It will be appreciated that during the transfer from the perfusion support module 100 to the normothermic perfusion module 200, the renal vein needs to be connected to the venous connection end 9 of the normothermic perfusion module 200 by the renal vein circulation switching module 7, and the lost blood and blood pressure are replenished by the first liquid charger 6 due to the continuous loss of venous blood
In the embodiment of the application, firstly, the perfusion support module 100 is used for in-vivo perfusion, and then, in the kidney separation process, the kidney venous circulation switching module 7 and the kidney arterial circulation switching module 8 are used for complete transfer, so that cold perfusion preservation is not needed by perfusion of a refrigerating fluid, the ischemia time of the kidney is shortened, and meanwhile, secondary damage caused by the refrigerating fluid is prevented, and the risk of PNF and DGF is reduced; finally, the normal temperature perfusion module 200 provides necessary substances and conditions for kidney repair, so that the kidney can quickly recover its original functions and the quality of kidney organs can be improved.
Further, the perfusion support module 100 may further include a first renal artery pressure control sub-module 60, the first renal artery pressure control sub-module 60 being disposed on a first line between the first centrifugal pump 3 and the donating artery.
It should be noted that, during the actual perfusion process, the arterial blood pressure may fluctuate, so in the embodiment of the present application, the first renal artery pressure control sub-module 60 performs pressure control on the arterial blood flowing into the donating artery, for example, the pressure of the arterial blood may be increased by a method of reducing the diameter of the first pipeline.
Further, the first renal artery pressure control sub-module 60 may also be disposed on the first line between the first fluid charger 6 and the donating artery.
It will be appreciated that as shown in fig. 1, both the perfusate from the first liquid charger 6 and the arterial blood from the first centrifugal pump 3 need to be pressure controlled by a renal artery pressure control sub-module to maintain renal pressure within a suitable range.
Further, the perfusion support module 100 may further comprise a first bubble filter 4.
It will be appreciated that bubbles may be generated in the blood during the oxygenation process, so in the embodiment of the present application, bubbles are eliminated by the first bubble filter 4, and therefore, the first bubble filter 4 only needs to be disposed between the first oxygenators 2; for example, the first bubble trap 4 may be provided in the first line between the first oxygenator 2 and the first centrifugal pump 3, or in the first line between the first centrifugal pump 3 and the donating artery.
Further, the perfusion support module 100 may further comprise a first flow sensor 5, the first flow sensor 5 being arranged on the first line between the first centrifugal pump 3 and the donating artery.
The flow rate of arterial blood is monitored by the first flow sensor 5, so that the flow rate of arterial blood is controlled within a reasonable range by adjusting the power of the first centrifugal pump 3.
Further, the normothermic perfusion module 200 may include a second circuit, an organ storage platform 11, a second filter 13, a second oxygenator 18, a second centrifugal pump 20, a second bubble filter 19, a temperature control sub-module 22, a blood preservation bag 16, a bubble monitor 21, and an arterial blood perfusion pressure control sub-module 24.
The organ storage platform 11 is used for placing the isolated kidney and controlling the temperature of the kidney within a preset range.
The venous connection end 9 and the arterial connection end 10 can be respectively arranged on the organ storage platform 11, an isolated kidney can be arranged in the organ storage platform 11, the venous connection end 9 is connected with the donor renal vein through the renal vein circulation switching module 7, and the arterial connection end 10 is connected with the donor renal artery through the renal artery circulation switching module 8.
The venous connection terminal 9, the second filter 13, the blood storage bag 16, the second oxygenator 18, the second centrifugal pump 20, the temperature control submodule 22, the arterial blood perfusion pressure control submodule 24 and the arterial connection terminal 10 are sequentially communicated through a second pipeline.
It will be appreciated that the second filter 13 acts the same as the first filter 1 for filtering blood clots and impurities flowing from the renal veins to prevent clogging of the subsequent passing devices; the second oxygenator 18, the second centrifugal pump 20, and the arterial blood perfusion pressure control submodule 24 function in the same manner as the first oxygenator 2, the first centrifugal pump 3, and the first renal arterial pressure control submodule 60, respectively, and are not described in detail herein.
It should be noted that, because the infusion of the normothermic infusion module 200 is still performed in vitro and the temperature is easily changed, and the infusion of the infusion support module 100 is performed in vivo, the embodiment of the present application controls the arterial blood temperature flowing into the kidney through the temperature control sub-module 22.
A second bubble filter 19 and a bubble monitor 21 are in turn arranged in the line between the second oxygenator 18 and the temperature control sub-module 22.
It will be appreciated that, as with the first bubble trap 4, the second bubble trap 19 needs to be located after the second oxygenator 18; and because the in-vivo perfusion time is shorter and the in-vitro perfusion time is longer, bubbles are easier to appear along with the extension of the perfusion time, so the embodiment of the application sets up the bubble monitor 21 to detect the bubbles in the blood so as to control the bubbles according to the detection result.
In the embodiment of the present application, venous blood flows into the blood preservation bag 16 for preservation, so in the process that the renal vein circulation switching module 7 drains venous blood of a donor renal vein to the normal temperature perfusion module 200, venous blood flows into the blood preservation bag 16 for preservation, and when the venous blood volume reaches a preset volume, the connection between the renal artery and the renal artery connection end 10 can be completed through the renal artery circulation switching module 8.
Further, the normothermic perfusion module 200 further includes a venous blood perfusion pressure control device 12. The venous blood perfusion pressure control device 12 is disposed on the line between the second filter 13 and the venous connection 9.
Further, the normothermic perfusion module 200 can also include a second fluid charger 17 in communication with the blood storage bag 16 for replenishing nutrients to the blood in the blood storage bag 16.
Further, the normothermic perfusion module 200 may also include a blood flow rate sensing sub-module 23 disposed in the line between the second centrifugal pump 20 and the arterial blood perfusion pressure control sub-module 24.
The blood flow rate sensing sub-module 23 is used to monitor the flow rate of arterial blood, like the first flow rate sensor 5, so that the flow rate of arterial blood can be controlled within a reasonable range by adjusting the power of the first centrifugal pump 3 according to the monitoring result.
Further, the normothermic perfusion module 200 may also include a metabolite monitoring submodule 15;
the metabolite monitoring submodule 15 is arranged on the line between the second centrifugal pump 20 and the arterial blood perfusion pressure control submodule 24 and/or on the line between the second filter 13 and the blood preservation bag 16.
In the embodiment of the application, the metabolites of venous blood and arterial blood can be monitored simultaneously, and lost metabolites can be accurately added to the kidney by monitoring the change value of the metabolites, so that the balance of the environment in the kidney is better maintained; meanwhile, the change value of the metabolite can also be used for accurately assessing the state of the kidney.
Further, the normothermic perfusion module 200 may also include an oximetry sub-module 14;
the blood oxygen monitoring submodule 14 is arranged on the line between the second centrifugal pump 20 and the arterial blood perfusion pressure control submodule 24 and/or on the line between the second filter 13 and the blood preservation bag 16.
It can be understood that the embodiment of the application can also monitor the oxygen of venous blood and arterial blood at the same time, and can accurately add the lost oxygen to the kidney by monitoring the change value of the oxygen, thereby better keeping the balance of the environment in the kidney; meanwhile, the change value of oxygen can also be used for accurately evaluating the state of the kidney.
Further, the ambient infusion module 200 may also include a urine collector 25;
the organ storage platform 11 is also provided with a urine collection pipe through which the urine collector 25 communicates with the three-dimensional kidney.
Embodiments of the present application can assess the condition of the kidney by measuring the amount of urine in urine collector 25.
Further, the normothermic perfusion module 200 may also include a renal tubule function monitoring sub-module 26 disposed on the urine collection conduit.
According to the embodiment of the application, the chemical substance content in urine is monitored in real time through the tubular function monitoring submodule 26, more kidney function information is provided for an operator, independent sampling is not needed for detection, and complicated operation is reduced.
Further, the kidney perfusion apparatus may further comprise an organ assessment system coupled to each working device for assessing kidney status based on perfusion parameters of each working device.
The working devices include a perfusion support module 100, a normothermic perfusion module 200, a renal venous circulation switching module 7, and a renal arterial circulation switching module 8.
The perfusion parameters may include power changes of the first centrifugal pump 3, metabolite changes of arterial blood and venous blood, pressure values, blood oxygen values, air bubble conditions, and other relevant parameters, which are not illustrated herein.
In the embodiment of the application, the organ evaluation system collects perfusion parameters, can integrate the perfusion parameters into a data chart and a trend chart, evaluates the kidney state, and feeds back the evaluation result to an operator so as to provide more objective data reference and reduce the risk of PNF and DGF of the transplanted organ.
The above is a detailed description of the structure and connection manner of a kidney perfusion device, and for convenience of understanding, the following description will describe an application of the kidney perfusion device in a specific application scenario, where the application examples include:
the kidneys are first perfused in vivo by the perfusion support module 100: firstly, a first filter 1 is communicated with a donor vein through a first pipeline, power is provided by a first centrifugal pump 3 to obtain venous blood from the donor vein, then the venous blood is filtered by the first filter 1, then the venous blood is oxygenated by a first oxygenator 2 to become arterial blood, then the arterial blood is provided with power by the first centrifugal pump 3 to simulate heart pulse perfusion blood, then the arterial blood is subjected to bubble filtration by a first bubble filter 4, finally, the arterial blood is conveyed to a donor artery after being subjected to pressure control by a first renal artery pressure control submodule 60, and the arterial blood flows into a kidney in the donor, so that the kidney is provided with blood, nutrients and the like to maintain the kidney function;
after the perfusion support module 100 is perfused for a period of time in vivo, the renal vein circulation switching module 7 is adopted for switching, one end of the renal vein circulation switching module 7 is communicated with a renal vein, and the other end of the renal vein circulation switching module 7 is communicated with the vein connecting end 9, so that venous blood flowing out of the renal vein flows into the blood preservation bag 16 through the venous blood perfusion pressure control device 12, the second filter 13, the blood oxygen monitoring submodule 14 and the metabolite monitoring submodule 15 in sequence; simultaneously, the first liquid feeder 6 is utilized to supplement perfusion liquid to the donor renal artery so as to supplement lost blood and blood pressure; venous blood flowing from the blood bag 16 passes through the second oxygenator 18, the second bubble filter 19, the second centrifugal pump 20, the metabolite monitoring module, the bubble monitor 21, the blood oxygen monitoring sub-module 14, the temperature control sub-module 22, the blood flow rate sensing sub-module 23, and the arterial blood perfusion pressure control sub-module 24 in sequence to the arterial connection end 10.
When venous blood in the blood storage bag 16 reaches a preset quantity, a renal artery circulation switching module 8 is used for switching, other blood vessels except the renal artery are closed, wherein the renal artery can be a renal artery, one end of the renal artery circulation switching module 8 is communicated with the renal artery, and the other end of the renal artery circulation switching module is communicated with an arterial connecting end 10, so that arterial blood flows back to the renal artery, and perfusion is completed.
The above embodiments are merely for illustrating the technical solution of the present application, and not for limiting the same; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit and scope of the corresponding technical solutions.
Claims (4)
1. A kidney perfusion device, comprising: the device comprises a perfusion support module, a normal temperature perfusion module, a renal vein circulation switching module and a renal artery circulation switching module;
the kidney vein circulation switching module is used for connecting a donor kidney vein with a vein connecting end of the normal-temperature perfusion module so as to drain venous blood of the donor kidney vein into the normal-temperature perfusion module;
the renal artery circulation switching module is used for connecting a donor renal artery with an artery connecting end of the normal-temperature perfusion module so as to lead arterial blood output by the normal-temperature perfusion module to flow back to the donor renal artery;
the perfusion support module comprises a first pipeline, a first filter, a first oxygenator, a first centrifugal pump, a first liquid filler, a first renal artery pressure control submodule, a first bubble filter and a first flow sensor;
the first filter, the first oxygenator and the first centrifugal pump are sequentially communicated through the first pipeline, the first filter is used for being communicated with a donor vein, and the first centrifugal pump is used for being communicated with a donor artery;
the first liquid filling device is used for being communicated with the donor artery, and replenishing perfusion liquid to the donor renal artery while the venous blood is drained by the renal venous circulation switching module;
the normal temperature perfusion module is used for perfusion of kidneys;
the first renal artery pressure control submodule is arranged on a first pipeline between the first centrifugal pump and the donor artery;
the first renal artery pressure control submodule is further arranged on a first pipeline between the first liquid feeder and the donor artery;
the first bubble filter is arranged on a first pipeline between the first oxygenator and the first centrifugal pump or on a first pipeline between the first centrifugal pump and the donor artery;
the first flow sensor is arranged on a first pipeline between the first centrifugal pump and the donor artery;
the normal temperature perfusion module comprises a second pipeline, an organ storage platform, a second filter, a second oxygenator, a second centrifugal pump, a second bubble filter, a temperature control submodule, a blood storage bag, a bubble monitor, an arterial blood perfusion pressure control submodule, a venous blood perfusion pressure control device, a second liquid filler communicated with the blood storage bag, a blood flow velocity sensing submodule arranged on the pipeline between the second centrifugal pump and the arterial blood perfusion pressure control submodule, a metabolite monitoring submodule and a blood oxygen monitoring submodule;
the organ storage platform is used for placing the isolated kidney and controlling the temperature of the kidney within a preset range;
the vein connecting end and the artery connecting end are respectively arranged on the organ storage platform;
the venous connection end, the second filter, the blood storage bag, the second oxygenator, the second centrifugal pump, the temperature control sub-module, the arterial blood perfusion pressure control sub-module and the arterial connection end are sequentially communicated through the second pipeline;
the second bubble filter and the bubble monitor are sequentially arranged on a pipeline between the second oxygenator and the temperature control submodule;
the venous blood perfusion pressure control device is arranged on a pipeline between the second filter and the venous connection end;
the second liquid adding device is used for supplementing nutrient substances for blood in the blood preservation bag;
the metabolite monitoring submodule is arranged on a pipeline between the second centrifugal pump and the arterial blood perfusion pressure control submodule and/or a pipeline between the second filter and the blood preservation bag;
the blood oxygen monitoring submodule is arranged on a pipeline between the second centrifugal pump and the arterial blood perfusion pressure control submodule and/or a pipeline between the second filter and the blood preservation bag;
the kidney perfusion device is used for carrying out kidney perfusion through a perfusion support module, the kidney venous circulation switching module and the kidney arterial circulation switching module, and comprises:
the perfusion support module is used for providing power to acquire venous blood from a donor vein when the first filter is communicated with the donor vein through the first pipeline, the first filter is used for filtering the acquired venous blood, the first oxygenator is used for oxygenating the filtered venous blood to enable the venous blood to become arterial blood, the first centrifugal pump is also used for providing power to simulate heart pulse perfusion blood, the first bubble filter is used for filtering out air bubbles from the arterial blood, the first renal artery pressure control submodule is used for controlling the pressure of the arterial blood after the air bubbles are filtered out and then conveying the arterial blood to the donor artery, and the arterial blood flows into kidneys in the donor;
the kidney vein circulation switching module is specifically used for enabling venous blood flowing out of the kidney vein to flow into the blood preservation bag sequentially through the venous blood perfusion pressure control device, the second filter, the blood oxygen monitoring submodule and the metabolite monitoring submodule after the kidney vein circulation switching module is filled for a preset time in the perfusion support module body, wherein one end of the kidney vein circulation switching module is communicated with a kidney vein, the other end of the kidney vein circulation switching module is communicated with a vein connection end; the first liquid feeder is used for supplementing perfusion liquid to the donor renal artery so as to supplement lost blood and blood pressure; venous blood flowing out of the blood storage bag sequentially passes through a second oxygenator, a second bubble filter, a second centrifugal pump, a metabolite monitoring module, a bubble monitor, a blood oxygen monitoring sub-module, a temperature control sub-module, a blood flow rate sensing sub-module and an arterial blood perfusion pressure control sub-module to reach an arterial connecting end;
the renal artery circulation switching module is specifically used for sealing other blood vessels except the renal artery when venous blood in the blood storage bag reaches a preset amount, one end of the renal artery circulation switching module is communicated with the renal artery, and the other end of the renal artery circulation switching module is communicated with the arterial connecting end, so that arterial blood flows back to the renal artery, and perfusion is completed.
2. The kidney perfusion device of claim 1, wherein the normothermic perfusion module further comprises a urine collector;
the organ storage platform mulberry is also provided with a urine collection pipeline;
the urine collector is in communication with the ex vivo kidney through the urine collection conduit.
3. The kidney perfusion device of claim 2, wherein the normothermic perfusion module further includes a tubular function monitoring sub-module disposed on the urine collection tube.
4. A renal perfusion apparatus according to any one of claims 1 to 3, further comprising an organ assessment system coupled to each working device for assessing renal status based on perfusion parameters of each working device.
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| CN202999168U (en) * | 2012-12-18 | 2013-06-19 | 武汉大学 | Isolated kidney continuous perfusion preservation device |
| CN104186459A (en) * | 2014-08-07 | 2014-12-10 | 中国人民解放军第三〇九医院 | Sub-normal-temperature or low-temperature isolated kidney storage device |
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| CN204682347U (en) * | 2014-12-04 | 2015-10-07 | 宋涂润 | For preserving the normal temperature filling system of human organ |
| CN106998676A (en) * | 2014-12-12 | 2017-08-01 | D·弗里德 | Apparatus and method for organ perfusion |
| CN209711249U (en) * | 2019-02-01 | 2019-12-03 | 陈建轩 | A kind of renal perfusion device |
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Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN202999168U (en) * | 2012-12-18 | 2013-06-19 | 武汉大学 | Isolated kidney continuous perfusion preservation device |
| CN104186459A (en) * | 2014-08-07 | 2014-12-10 | 中国人民解放军第三〇九医院 | Sub-normal-temperature or low-temperature isolated kidney storage device |
| CN104430302A (en) * | 2014-12-04 | 2015-03-25 | 宋涂润 | Normal-temperature perfusion system for storing human organs |
| CN204682347U (en) * | 2014-12-04 | 2015-10-07 | 宋涂润 | For preserving the normal temperature filling system of human organ |
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| CN209711249U (en) * | 2019-02-01 | 2019-12-03 | 陈建轩 | A kind of renal perfusion device |
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