肝癌肝移植的全流程管理  

Full-process management of liver transplantation for hepatocellular carcinoma

作　　者：吴广东 卢倩 Wu Guangdong;Lu Qian(Hepatobiliary Pancreatic Center,Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University,Key Laboratory of Digital Intelligence Hepatology of Ministry of Education,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院肝胆胰中心、清华大学临床医学院数智肝胆病学教育部重点实验室,北京102218

出　　处：《器官移植》2025年第2期214-219,共6页Organ Transplantation

基　　金：研究型病房卓越临床研究计划项目(BRWEP2024W032240100)。

摘　　要：肝细胞癌(HCC)是临床最常见的癌症之一,肝切除和肝移植是目前治疗HCC的重要手段,但对于合并有终末期肝病的患者,肝移植是最佳选择,其可在完整切除病灶的同时恢复正常的肝功能。但HCC肝移植面临供肝短缺和术后肿瘤高复发转移风险,如何选取HCC患者进行肝移植,有效改善HCC肝移植预后成为临床关注的热点问题,涉及从术前精准评估到术后远期随访等多个环节。因此,本文就术前、术中、术后管理方面以及多学科综合诊疗制度在HCC肝移植中的应用,对HCC肝移植的全流程管理进行评述,以期为改善HCC肝移植受者的预后提供参考。Hepatocellular carcinoma(HCC)is one of the most common cancers in clinical practice.Hepatectomy and liver transplantation are currently important treatment modalities for HCC.However,for patients with end-stage liver disease,liver transplantation is the optimal choice,as it can completely resect the tumor while restoring normal liver function.Nevertheless,clinical liver transplantation for HCC faces challenges such as a shortage of donor livers and a high risk of postoperative tumor recurrence and metastasis.How to select HCC patients for liver transplantation and effectively improve the prognosis of HCC liver transplantation has become a hot topic in clinical practice,involving multiple aspects from preoperative precise evaluation to long-term postoperative follow-up.Therefore,this article reviews the full-process management of HCC liver transplantation,including preoperative management,surgical management,postoperative management and the application of multidisciplinary comprehensive treatment in HCC liver transplantation,in order to provide references for improving the prognosis of HCC liver transplant recipients.

关 键 词：肝细胞癌 肝移植 米兰标准 降期治疗 桥接治疗 复发转移 免疫抑制药 多学科综合诊疗 

分 类 号：R617[医药卫生—外科学] R735.7[医药卫生—临床医学]