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肝移植治疗肝内胆管癌的现状与进展

Current status and progress of liver transplantation for intrahepatic cholangiocarcinoma

摘要肝内胆管癌是一种侵袭性强的肝癌类型,传统的肝切除效果有限。近来,肝移植作为一种潜在的治疗手段备受关注。肝移植的选择标准一直是研究的热点。早期患者,肝移植可提供良好的生存率;晚期或不可常规切除的局部晚期患者,肝移植的效果仍有待进一步验证。鉴于供体的短缺,活体供肝及扩展标准的供肝逐渐被应用到肝内胆管癌的患者中。另外,辅助治疗及新辅助治疗的兴起,给部分晚期或不可常规切除的肝内胆管癌患者接受肝移植治疗带来了希望。特别是免疫检查点抑制剂的应用,未来可能作为肝移植的过渡治疗或辅助治疗。自体肝移植、异种肝移植的开展及探索,给肝内胆管癌的治疗带来了新的视野。本文通过阅读相关文献,就肝移植在肝内胆管癌治疗中的应用现状及进展作一综述。

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abstractsIntrahepatic cholangiocarcinoma is a highly aggressive type of liver cancer, and traditional hepatectomy has shown limited efficacy. Recently, liver transplantation has garnered attention as a potential therapeutic option. The criteria for selecting patients for liver transplantation have been a focal point of research. For early-stage patients, liver transplantation can offer favorable survival rates; however, for those with advanced or locally advanced cases that are not amenable to conventional resection, the efficacy of liver transplantation remains to be further validated. Given the scarcity of donors, living donor liver transplantation and extended criteria donor liver transplantation are gradually being applied to patients with intrahepatic cholangiocarcinoma. Additionally, the advent of adjuvant and neoadjuvant therapies has brought hope to some advanced or conventionally unresectable intrahepatic cholangiocarcinoma patients who undergo liver transplantation. Particularly, the use of immune checkpoint inhibitors may serve as a bridging or adjunct therapy for liver transplantation in the future. The development and exploration of autologous and xenogeneic liver transplantation have introduced new perspectives. This paper provides a review of the current status and progress of liver transplantation in the treatment of intrahepatic cholangiocarcinoma based on relevant literature.

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