Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Province, Hangzhou, China.
NHC Key Laboratory of Combined Multi-organ Transplantation, Zhejiang Province, Hangzhou, China.
Transplantation. 2024 Aug 1;108(8):1730-1748. doi: 10.1097/TP.0000000000004913. Epub 2024 Feb 5.
Organ transplantation is the preferred paradigm for patients with end-stage organ failures. Despite unprecedented successes, complications such as immune rejection, ischemia-reperfusion injury, and graft dysfunction remain significant barriers to long-term recipient survival after transplantation. Conventional immunosuppressive drugs have limited efficacy because of significant drug toxicities, high systemic immune burden, and emergence of transplant infectious disease, leading to poor quality of life for patients. Nanoparticle-based drug delivery has emerged as a promising medical technology and offers several advantages by enhancing the delivery of drug payloads to their target sites, reducing systemic toxicity, and facilitating patient compliance over free drug administration. In addition, nanotechnology-based imaging approaches provide exciting diagnostic methods for monitoring molecular and cellular changes in transplanted organs, visualizing immune responses, and assessing the severity of rejection. These noninvasive technologies are expected to help enhance the posttransplantation patient survival through real time and early diagnosis of disease progression. Here, we present a comprehensive review of nanotechnology-assisted strategies in various aspects of organ transplantation, including organ protection before transplantation, mitigation of ischemia-reperfusion injury, counteraction of immune rejection, early detection of organ dysfunction posttransplantation, and molecular imaging and diagnosis of immune rejection.
器官移植是治疗终末期器官衰竭患者的首选方案。尽管取得了前所未有的成功,但免疫排斥、缺血再灌注损伤和移植物功能障碍等并发症仍然是移植后受体长期存活的重大障碍。由于药物毒性大、全身免疫负担高以及移植后传染病的出现,传统的免疫抑制药物疗效有限,导致患者生活质量下降。基于纳米粒子的药物递送技术已成为一种很有前途的医疗技术,通过增强药物有效载荷向靶部位的递送、降低系统毒性以及提高患者对药物的顺应性,优于传统的药物给药方式,具有多种优势。此外,基于纳米技术的成像方法为监测移植器官中的分子和细胞变化、可视化免疫反应以及评估排斥反应的严重程度提供了令人兴奋的诊断方法。这些非侵入性技术有望通过实时和早期诊断疾病进展,帮助提高移植后患者的生存率。本文全面综述了纳米技术辅助的各种器官移植策略,包括移植前器官保护、减轻缺血再灌注损伤、对抗免疫排斥、移植后早期检测器官功能障碍以及免疫排斥的分子成像和诊断。