儿童肝移植的挑战与展望

Current challenges and future perspectives of pediatric liver transplantation

随着儿童肝移植手术技术和围手术期管理水平的快速发展,儿童肝移植受者存活率得到显著提高,如何进一步扩大供肝来源、降低等待期病死率和围手术期并发症发生率、提高移植受者术后长期生活质量成为未来的研究重点。通过手术技术创新和机械灌注提高供肝利用率和术后恢复速度、采用微创手术和基因编辑技术将肝移植治疗从巨创转变为微创、建立肝移植术后免疫抑制剂个体化用药方案、寻找规范有效的免疫耐受诱导方法将成为未来儿童肝移植领域的重要研究方向。

With a rapid development of surgery technology and perioperative management in the field of pediatric liver transplantation(LT),survival rate of pediatric LT recipients has greatly improved.How to further expand the source of liver donors,lower the mortality rate during waiting period and reduce the incidence of perioperative complications have become the focal topics of future researches.Improving liver donor utilization and postoperative recovery speed through surgical technology innovation and mechanical perfusion,employing mini-invasive surgery and gene editing technology for transforming LT from highly to minimally invasive,formulating individualized immunosuppressant protocols and exploring effective immune tolerance induction modes shall dominate in the field of pediatric LT.