异种肝移植的探索之路:从科学研究走向临床应用  

Exploratory road of liver xenotransplantation:from scientific research to clinical application

作　　者：李霄 曹薇薇 余良 Li Xiao;Cao Weiwei;Yu Liang(Department of General Surgery,Xijing Hospital of Air Force Medical University,Xi’an 710032,China;不详)

机构地区：[1]空军军医大学西京医院综合外科,西安710032 [2]空军军医大学西京医院检验科,西安710032 [3]空军军医大学西京医院信息科,西安710032

出　　处：《器官移植》2024年第5期758-763,共6页Organ Transplantation

基　　金：国家自然科学基金(82070681、81970566);陕西省重点研发计划资助项目(2023-YBSF-429);陕西省自然科学基础研究计划资助项目(2022JM-537)。

摘　　要：随着手术技术进步及围手术期管理水平提升,器官移植受者及移植物存活率显著提高,供器官短缺已成为限制器官移植进一步发展的主要障碍。近期,以基因修饰猪为供体的异种肾移植和异种心脏移植已进入临床试验并取得了不错的效果,异种移植再一次成为生物医学研究的热点。与心脏和肾脏相比,基因修饰猪的肝脏在非人灵长类动物体内的存活时间还比较短,且实验结果差异性较大,尚不具备进入临床试验的条件。因此,本文从术式选择、凝血功能障碍和急性血管性排斥反应3个方面,总结目前异种肝移植的研究进展,讨论阻碍异种肝移植进入临床试验的主要问题及可能的解决策略,以期为异种肝移植从科学研究走向临床提供参考。With the advancement of surgical technologies and the improvement of perioperative management,the survival rates of organ transplant recipients and grafts have been significantly elevated.Shortage of donor organs has become the main obstacle to further development of organ transplantation.Recently,kidney and heart xenotransplantation with genetically modified pigs as donors have entered clinical trials and achieved favorable results.Xenotransplantation has repeatedly become a hot spot in biomedical research.Compared with heart and kidney,the survival time of liver grafts from genetically modified pigs in non-human primates is shorter.Besides,experimental results are dramatically different.Hence,it is not eligible for clinical trials.Consequently,recent research progress in xenotransplantation was reviewed from surgical pattern selection,coagulation dysfunction and acute vascular rejection,advances in liver xenotransplantation were summarized,and the main problems hindering xenotransplantation from entering clinical trials and potential solutions were illustrated,aiming to provide reference for xenotransplantation from scientific research to clinical application.

关 键 词：异种移植 肝移植 供者短缺 基因修饰猪 全肝移植 辅助性肝移植 凝血功能障碍 急性血管性排斥反应 

分 类 号：R617[医药卫生—外科学] Q78[医药卫生—临床医学]