肝癌肝移植临床研究回顾与展望

Review and prospect of clinical study on fiver transplantation of hepatocefiular carcinoma

过去十多年间肝癌肝移植临床研究的热点主要有：（1）适应证的适度放宽，使有限的供肝资源得到更公平、合理的使用。多个新的适应证标准被提出并被验证。我国学者提出的适合国情的标准，在不显著影响疗效的同时使更多肝癌患者受益于肝移植治疗。（2）探索合适的免疫抑制方案，在控制排异的同时预防和减少移植术后肿瘤的复发。目前，还没有足够的临床试验数据进行结论，但对于高复发风险患者，建议其在肝移植术后尽量减少钙调素抑制剂的用量并转换为mTor抑制剂。近年，肿瘤精准医学和免疫治疗技术飞速发展，为肝癌肝移植研究提供了新的机遇。

The focus of clinical research on liver transplantation of hepatocellular carcinoma over past decade is as follows： （1） the appropriate indications, so that the limited liver resources can be used more fairly and reasonably. A number of new indications standards have been proposed and validated. Our cotmtry scholar puts forward the standard norms, which could benefit more liver cancer patients from liver transplant. （2） To explore the appropriate regimen in the control of rejection while preventing and reducing tumor recurrence rate after transplantation. At present, there is not enough clinical trial data to conclude, but for patients with high recurrence risk, it is recommended to minimize the dosage of calmodulin inhibitors and convert them to mTOR inhibitors after liver transplantation. In recent years, the rapid development of cancer precision medicine and immunotherapy technology has provided new opportunities for the study of liver transplantation in liver cancer.