Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK.
Institute of Transplantation, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK.
Eur J Surg Oncol. 2019 Dec;45(12):2268-2278. doi: 10.1016/j.ejso.2019.07.024. Epub 2019 Jul 24.
Indications for liver transplantation have expanded over the past few decades owing to improved outcomes and better understanding of underlying pathologies. In particular, there has been a growing interest in the field of transplant oncology in recent years that has led to considerable developments which have pushed the boundaries of malignant indications for liver transplantation beyond hepatocellular carcinoma (HCC). In this article, we review and summarise the published evidence for liver transplantation in non-HCC primary and metastatic liver malignancies and highlight ongoing clinical trials that address unresolved questions therein. We also examine the current technical, immunological and oncological challenges that face liver transplantation in this growing field and explore potential approaches to overcome these barriers.
由于治疗效果的提高和对潜在病理的更好理解,肝移植的适应证在过去几十年中不断扩大。特别是,近年来移植肿瘤学领域的兴趣日益浓厚,这导致了相当多的发展,推动了肝癌(HCC)以外的肝移植恶性适应证的界限。在本文中,我们回顾和总结了非 HCC 原发性和转移性肝恶性肿瘤肝移植的已发表证据,并强调了正在解决其中未解决问题的临床试验。我们还检查了当前在这个不断发展的领域中肝移植所面临的技术、免疫和肿瘤学挑战,并探讨了克服这些障碍的潜在方法。