异种肝移植中的急性体液性排斥反应
DOI: 10.3969/j.issn.1001-5256.2022.10.003
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摘要: 肝移植是各种终末期肝病最为有效的治疗手段。肝脏供体的严重短缺导致大量终末期肝病患者死亡。利用基因工程技术研发的基因工程猪作为供体,是目前最有可能解决肝脏供体短缺的办法之一。虽然,目前基因工程猪-非人灵长类动物异种肝移植术后发生的急性排斥反应、血小板减少症、凝血异常等问题阻碍了异种肝脏的临床应用,但基因工程技术的发展以及新型免疫抑制剂的应用,异种肝移植急性排斥反应在一定程度上得到了控制。目前,急性体液性排斥反应可能是导致较长时间存活的移植物失功的主要因素。因此,明确异种肝移植中的急性体液性排斥反应的机制及处理方法,对于目前我国今后开展异种肝移植研究具有重要的意义。Abstract: Liver transplantation is a curable therapy to save the life of patients with end-stage liver diseases of different causes. The serious shortage of liver donors led to the death of a large number of patients with end-stage liver disease. Genetic-engineered pigs used for xenotransplantation are one of the potential solutions to alleviate the liver donor shortage, but currently clinical application of such xenogeneic liver grafts is hindered by acute rejection, thrombocytopenia, and coagulation dysfunctions in patients. The development of genetic-engineering technology and the application of new immunosuppressants have controlled the acute rejection of liver xenotransplantation to some extent. However, acute humoral rejection may become another major issue for the long-term graft failure. This review summarized and discussed the potential and underlying mechanisms and preventive measures of acute humoral rejection in liver xenotransplantation.
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表 1 基因工程猪-非人灵长类动物异种肝移植受体存活时间
Table 1. Survival time of genetically engineered pig - nonhuman primate xenotransplantation recipients
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