“废弃肝”辅助性肝移植的创新临床应用与前景展望

Auxiliary liver transplantation using discarded liver: innovative clinical applications and future perspectives

摘要:

“废弃肝”是指从切除病肝上分离出的功能肝段，其作为小体积移植物应用于辅助性肝移植为扩大供肝来源提供新的思路。近年来，随着“废弃肝”概念的进一步拓展延伸，“废弃肝”移植与分期肝切除等术式的合理结合应用，以及异种移植领域的快速发展，“废弃肝”辅助性肝移植为移植等待患者提供了更多的治疗选择方案。而如何实现“废弃肝”的创新临床应用，其进一步推广的前景与方向，是肝移植领域需要关注的重要课题。本文结合国内外研究进展及作者团队的临床实践，系统总结“废弃肝”辅助性肝移植的技术演变与应用现状，重点讨论其创新术式、“废弃肝”与异种移植相结合的潜在临床价值，并对该技术的安全实施及个体化手术决策提出展望。

Abstract:

Discarded liver refers to functional liver segments separated from resected diseased livers. When used as small-volume grafts in auxiliary liver transplantation, discarded livers provide a novel strategy for expanding the donor pool. In recent years, with the further extension of the discarded liver concept, the rational integration of discarded liver transplantation with staged hepatectomy and other surgical techniques, together with rapid advances in the field of xenotransplantation, has offered additional therapeutic options for patients awaiting liver transplantation. How to achieve innovative clinical applications of discarded livers, as well as the prospects and directions for their wider adoption, has become an important issue in the field of liver transplantation. Based on current domestic and international evidence and the authors'clinical experience, this paper systematically summarizes the technical evolution and current applications of auxiliary liver transplantation using discarded livers, with a particular focus on innovative surgical strategies, the potential clinical value of combining discarded liver transplantation with xenotransplantation, and future perspectives on the safe implementation and individualized surgical decision-making of this approach.