2024年全球肝移植研究年度盘点——技术突破、精准管理与未来挑战OA北大核心
Annual review of global liver transplantation research in 2024:technological breakthroughs,precision management and future challenges
近年来肝移植领域在供者扩展、技术创新及围手术期管理方面取得显著进展.机械灌注技术通过动态修复与评估供肝质量,能有效减少术后并发症,提高边缘供肝利用率.劈离式肝移植技术的优化与常温灌注技术结合,进一步缓解供者短缺问题,但其推广仍受技术门槛的限制.异种移植在基因修饰猪肝脏领域取得临床前突破,但伦理与免疫屏障问题亟待解决.肝癌肝移植领域聚焦免疫检查点抑制剂的新辅助治疗及复发预测模型的开发,推动精准治疗.对于围手术期管理,个体化免疫抑制方案、人工肝支持及血管并发症防控策略的优化显著提升患者生存率.针对儿童、高龄及合并多重疾病受者的个性化治疗为特殊人群的肝移植治疗提供新思路.未来,肝移植研究应聚焦多学科交叉、个体化治疗和新兴技术的融合,推动全球肝移植事业迈向新的高度.
In recent years,significant progress has been made in the field of liver transplantation in terms of donor expansion,technological innovation and perioperative management.Machine perfusion technology,through dynamic repair and assessment of donor liver quality,can effectively reduce postoperative complications and increase the utilization rate of marginal donor livers.The optimization of split liver transplantation technology combined with normothermic perfusion further alleviates the shortage of donors,but its promotion is still limited by technical barriers.Xenotransplantation has achieved preclinical breakthroughs in the field of genetically modified pig livers,but ethical and immune barrier issues need to be urgently resolved.In the field of liver cancer liver transplantation,the focus is on neoadjuvant treatment with immune checkpoint inhibitors and the development of recurrence prediction models,which promotes precise treatment.For perioperative management,the optimization of individualized immunosuppressive regimens,artificial liver support,and strategies for the prevention and control of vascular complications has significantly improved patients'survival rates.Personalized treatment for children,elderly recipients,and recipients with multiple comorbidities provides new ideas for liver transplantation in special populations.In the future,liver transplantation research may focus on the integration of multidisciplinary approaches,individualized treatment and emerging technologies to advance the global liver transplantation cause to new heights.
蒋勇;冯啸;刘炜;杨扬
510630 广州,中山大学附属第三医院肝脏外科暨肝移植中心中山大学器官移植研究所广东省肝脏疾病研究重点实验室广东省移植医学工程实验室510630 广州,中山大学附属第三医院肝脏外科暨肝移植中心中山大学器官移植研究所广东省肝脏疾病研究重点实验室广东省移植医学工程实验室510630 广州,中山大学附属第三医院肝脏外科暨肝移植中心中山大学器官移植研究所广东省肝脏疾病研究重点实验室广东省移植医学工程实验室510630 广州,中山大学附属第三医院肝脏外科暨肝移植中心中山大学器官移植研究所广东省肝脏疾病研究重点实验室广东省移植医学工程实验室
临床医学
肝移植供肝来源机械灌注劈离式肝移植异种移植肝癌肝移植围手术期管理并发症防控
Liver transplantationDonor liver sourceMachine perfusionSplit liver transplantationXenotransplantationLiver cancer liver transplantationPerioperative managementComplication prevention and control
《器官移植》 2025 (3)
350-358,9
国家重点研发计划(2024YFA1107200)国家自然科学基金(U24A20655、82172585)广州市科技计划项目(2024A03J0273)
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