Yu Lu, Xu Jun, Que Ting, Miao Zhezhi, Zhou Yifeng, Que Shuping, Zheng Shusen, Liu Zhengtao
Key Laboratory of Artificial Organs and Computational Medicine in Zhejiang Province, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China.
Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China.
Int J Med Sci. 2025 Jul 1;22(13):3202-3219. doi: 10.7150/ijms.113479. eCollection 2025.
Iron metabolism plays a pivotal role in liver transplantation, significantly impacting outcomes for both donors and recipients. The liver, central to iron homeostasis, is often impaired in chronic liver diseases leading to metabolic disorders that exacerbate liver damage. Liver transplantation (LT) is a critical treatment for end-stage liver diseases, with iron status in both donors and recipients influencing post-transplant outcomes. Studies indicate that pre-transplant iron overload in recipients is associated with poor liver function recovery, increased graft rejection risk, and reduced patient survival. The iron metabolic state of donors also affects the functionality of the transplanted liver, impacting transplant success and patient prognosis. Biomarkers such as hepcidin, serum ferritin, and total iron-binding capacity are significant predictors of LT prognosis, yet their specific roles and impacts remain inconclusive. This review systematically assesses how variations in iron metabolic levels of donors and recipients affect patient outcomes following LT, aiming to optimize iron metabolism regulation in clinical management to enhance transplant success, reduce postoperative complications, and improve long-term patient quality of life. Future research should focus on developing personalized iron metabolism management protocols to refine these approaches and enhance transplant care.
铁代谢在肝移植中起着关键作用，对供体和受体的结局均有重大影响。肝脏是铁稳态的核心器官，在慢性肝病中常受到损害，导致代谢紊乱，进而加剧肝损伤。肝移植（LT）是终末期肝病的关键治疗方法，供体和受体的铁状态都会影响移植后的结局。研究表明，受体移植前的铁过载与肝功能恢复不良、移植排斥风险增加以及患者生存率降低有关。供体的铁代谢状态也会影响移植肝脏的功能，从而影响移植成功率和患者预后。铁调素、血清铁蛋白和总铁结合力等生物标志物是肝移植预后的重要预测指标，但其具体作用和影响仍尚无定论。本综述系统评估了供体和受体铁代谢水平的变化如何影响肝移植术后患者的结局，旨在优化临床管理中的铁代谢调节，以提高移植成功率、减少术后并发症并改善患者的长期生活质量。未来的研究应专注于制定个性化的铁代谢管理方案，以完善这些方法并加强移植护理。
