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癌症的肝移植——当前挑战与新出现的解决办法

Liver Transplantation for Cancer-Current Challenges and Emerging Solutions.

作者信息

Elzein Steven M, Brombosz Elizabeth W, Kodali Sudha

机构信息

Department of Surgery, Houston Methodist Hospital, 6550 Fannin Street Suite 1661, Houston, TX 77030, USA.

Sherrie and Alan Conover Center for Liver Disease and Transplantation, J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, TX 77030, USA.

出版信息

J Clin Med. 2025 Jul 29;14(15):5365. doi: 10.3390/jcm14155365.

Abstract

Liver transplantation (LT) for hepatic malignancies is becoming increasingly common, largely because it offers superior survival relative to other treatment approaches. LT is well-accepted for primary liver cancers such as hepatocellular carcinoma and perihilar cholangiocarcinoma and is being increasingly accepted for intrahepatic cholangiocarcinoma and metastases of colorectal cancer or neuroendocrine tumors to the liver. Over time, indications for transplant oncology have broadened, as has the acceptable disease burden for transplantation, particularly with the advent of new neoadjuvant therapies. Other current frontiers in the field include expanding the donor pool through living donors, extended criteria donors, machine perfusion and increasing access to LT for people from disadvantaged socioeconomic backgrounds. Expanding access to LT can offer renewed hope for long-term survival to patients with primary and secondary liver cancer.

摘要

肝移植(LT)用于治疗肝脏恶性肿瘤正变得越来越普遍,这主要是因为相对于其他治疗方法,它能提供更高的生存率。LT已被广泛接受用于治疗原发性肝癌,如肝细胞癌和肝门周围胆管癌,并且越来越多地被用于治疗肝内胆管癌以及结直肠癌或神经内分泌肿瘤转移至肝脏的情况。随着时间的推移,移植肿瘤学的适应证不断扩大,移植可接受的疾病负担也在增加,特别是随着新辅助治疗方法的出现。该领域目前的其他前沿方向包括通过活体供体、扩大标准供体、机器灌注来扩大供体库,以及增加社会经济背景不利人群接受LT的机会。扩大LT的可及性可为原发性和继发性肝癌患者带来长期生存的新希望。

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