异种肝移植手术的特点与难点

Liver xenotransplantation techniques:Characteristics and difficulties

随着基因编辑技术的快速发展,以猪为供体的异种移植越来越接近临床实用。目前猪的心脏和肾脏在非人灵长类动物体内已实现长期存活,进行了初步的临床尝试并取得成功。而异种肝移植最长存活近1个月,也初步具备进入临床试验的条件。但与心脏和肾脏肝移植相比,异种肝移植因手术技术难度高、围手术期管理困难等原因,目前全世界仅有少数中心能够开展。本文试就目前已开展的异种肝移植术式进行综述,并分析其技术特点和难点,为未来开展此类手术试验提供经验与参考。

The rapid development of gene editing technology showed usefulness of pig xenotransplantation as a donor in clinical application.Clinical trials of non-human primates using pig heart and kidney were able to survive them for a long period of time,while the longest survival of xenograft liver transplantation was nearly 1 month,which could meet the conditions for entering clinical trials for human patients.However,compared with heart and kidney transplantation,only a few units in the world can carry out xenograft liver transplantation due to the high technical difficulty and difficult perioperative management.This review summarized the advancement and progress in the field and discussed the technical characteristics and difficulties,so as to provide experience and reference for the future development of clinical trials,i.e.,comparison of pig and liver anatomy,animal models of xenograft liver transplantation,and characteristics and difficulties in liver xenotransplantation technique.