2025年全球肝移植研究年度盘点

Annual review of global liver transplantation research in 2025

摘要

2025年，肝移植领域在异种移植、机械灌注、微创外科、精准免疫调控及人工智能等方向取得多项突破性进展。基因修饰猪-人辅助性肝移植的成功实施，标志着异种肝移植正式迈入临床转化阶段。机械灌注技术完成多项大规模临床验证，显著改善边缘供肝及心脏死亡供肝的移植结局，推动器官保存进入动态功能评估时代。劈离式肝移植及活体肝移植在供-受者匹配、供肝利用及围手术期管理方面持续优化。机器人与腹腔镜技术进一步推动肝移植向精准微创方向发展。肝细胞癌肝移植逐渐形成以免疫治疗、桥接降期及复发风险预测为核心的精准化管理模式。同时，人工智能与多组学技术在预后预测、器官分配及并发症风险评估中展现出重要应用价值。本文围绕2025年肝移植领域的重要研究进展进行系统综述，并对未来发展方向与挑战进行展望。

Abstract

In 2025, significant breakthroughs were achieved in various aspects of liver transplantation, including xenotransplantation, machine perfusion, minimally invasive surgery, precise immune regulation and artificial intelligence, etc. The successful implementation of gene-modified pig-to-human assisted liver transplantation marked the official entry of xenotransplantation into the clinical transformation stage. The machine perfusion technology completed multiple large-scale clinical validations, significantly improving the transplantation outcomes of marginal donor livers and donor livers from donation after cardiac death, and pushing organ preservation into the era of dynamic functional assessment. Split liver transplantation and living donor liver transplantation continuously optimized in terms of donor-recipient matching, liver utilization and perioperative management. Robotic and laparoscopic technologies further promoted liver transplantation towards the direction of precision and minimally invasive surgery. Hepatocellular carcinoma liver transplantation gradually formed a precise management model centered on immunotherapy, bridge downgrade and recurrence risk prediction. At the same time, artificial intelligence and multi-omics technologies demonstrated significant application value in prognosis prediction, organ allocation and complication risk assessment. This article conducts a systematic review of the important research progress in the field of liver transplantation in 2025 and looks forward to the future development directions and challenges.

关键词

肝移植 / 机械灌注 / 劈离式肝移植 / 异种移植 / 肝细胞癌 / 微创技术 / 人工智能 / 桥接降期

Key words

Liver transplantation / Machine perfusion / Split liver transplantation / Xenotransplantation / Hepatocellular carcinoma / Minimally invasive technique / Artificial intelligence / Bridge downgrade

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基金资助

国家重点研发计划(2024YFA1107200)

国家自然科学基金(U24A20655)

广州市科技计划项目(2025A03J4126)

广州市科技计划项目(2024A03J0273)