边缘供肝面临的机遇与挑战  

Opportunities and challenges of marginal donor liver

作　　者：鲁欣翼 滕飞 傅宏 赵渊宇 朱鲤烨 董家勇 毛家玺 郭闻渊 Lu Xinyi;Teng Fei;Fu Hong;Zhao Yuanyu;Zhu Liye;Dong Jiayong;Mao Jiaxi;Guo Wenyuan(Department of Organ Transplantation,the Second Affiliated Hospital of Naval Medical University(Shanghai Changzheng Hospital),Shanghai 200003,China)

机构地区：[1]海军军医大学第二附属医院(上海长征医院)器官移植科,上海200003 [2]海军军医大学免疫学教研室暨医学免疫学国家重点实验室

出　　处：《器官移植》2024年第3期463-468,共6页Organ Transplantation

基　　金：国家自然科学基金面上项目(82371792、81971503);医学免疫学国家重点实验室开放课题项目(NKLMI2023K03);海军军医大学校级基础医学研究课题项目(2022QN072)。

摘　　要：随着手术技术和术后免疫抑制治疗的不断突破与成熟,肝移植受者和移植物存活率显著提高,供肝短缺已成为限制肝移植临床发展的主要阻碍,如何扩大供肝来源也成为了当前迫切需要解决的问题。高龄供肝、脂肪变性供肝、病毒性肝炎供肝、心脏死亡器官捐献供肝等常见边缘供肝在临床肝移植中的使用已经取得了一定的突破性进展,但边缘供肝的使用仍存在较多限制。因此,本文对边缘供肝的定义,几种常见边缘供肝的应用及研究进展进行综述,探讨目前边缘供肝面临的机遇与挑战,旨在为临床肝移植供者池的扩大提供参考,造福更多终末期肝病患者。With persistent breakthrough and maturity of surgical procedures and postoperative immunosuppressive therapy,the survival rate of liver transplant recipients and grafts has been significantly increased.The shortage of donor liver has become the main obstacle for clinical development of liver transplantation.How to expand the source of donor liver has become an urgent issue.Groundbreaking progresses have been made in the use of common marginal donor livers in clinical liver transplantation,such as elderly donor liver,steatosis donor liver,viral hepatitis donor liver and liver from donation after cardiac death.Nevertheless,multiple restrictions still exist regarding the use of marginal donor liver.Consequently,the definition of marginal donor liver and research progress in the application of common marginal donor livers were reviewed,and the opportunities and challenges of mariginal donoor liver were illustrated,aiming to provide reference for expanding the donor pool for clinical liver transplantation and bringing benefits to more patients with end-stage liver disease.

关 键 词：肝移植 边缘供肝 高龄 脂肪变性 病毒性肝炎 劈离式肝移植 心脏死亡器官捐献 机械 

分 类 号：R617[医药卫生—外科学] R575[医药卫生—临床医学]