Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Surgery, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangdong, China.
J Hepatobiliary Pancreat Sci. 2021 Nov;28(11):913-930. doi: 10.1002/jhbp.882. Epub 2020 Dec 28.
Liver transplantation, the only proven treatment for end-stage liver disease and acute liver failure, is hampered by the scarcity of donors. Regenerative medicine provides an alternative therapeutic approach. Tremendous efforts dedicated to liver regenerative medicine include the delivery of transplantable cells, microtissues, and bioengineered whole livers via tissue engineering and the maintenance of partial liver function via extracorporeal support. This brief review summarizes the current status of regenerative medicine for the hepatobiliary system. For liver regenerative medicine, the focus is on strategies for expansion of transplantable hepatocytes, generation of hepatocyte-like cells, and therapeutic potential of engineered tissues in liver disease models. For biliary regenerative medicine, the discussion concentrates on the methods for generation of cholangiocyte-like cells and strategies in the treatment of biliary disease. Significant advances have been made in large-scale and long-term expansion of liver cells. The development of tissue engineering and stem cell induction technology holds great promise for the future treatment of hepatobiliary diseases. The application of regenerative medicine in liver still lacks extensive animal experiments. Therefore, a large number of preclinical studies are necessary to provide sufficient evidence for their therapeutic effectiveness. Much remains to be done for the treatment of hepatobiliary diseases with regenerative medicine.
肝移植是治疗终末期肝病和急性肝功能衰竭的唯一有效方法，但供体短缺限制了其应用。再生医学为治疗这些疾病提供了另一种选择。人们为肝再生医学付出了巨大努力，包括通过组织工程将可移植细胞、微组织和生物工程全肝递送至体内，以及通过体外支持来维持部分肝功能。本文简要综述了肝胆系统再生医学的研究现状。对于肝再生医学，重点在于研究扩大可移植肝细胞、生成肝样细胞的策略，以及工程组织在肝病模型中的治疗潜力。对于胆系再生医学，重点在于生成胆管细胞样细胞的方法和治疗胆系疾病的策略。在大规模和长期扩增肝细胞方面已经取得了显著进展。组织工程和干细胞诱导技术的发展为肝胆疾病的未来治疗带来了很大希望。再生医学在肝脏中的应用仍缺乏广泛的动物实验，因此需要进行大量的临床前研究，为其治疗效果提供充分的证据。再生医学治疗肝胆疾病还有许多工作要做。
