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首页> 外文期刊>Journal of Surgical Research: Clinical and Laboratory Investigation >Hepatocyte transplantation: past efforts, current technology, and future expansion of therapeutic potential
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Hepatocyte transplantation: past efforts, current technology, and future expansion of therapeutic potential

机译:肝细胞移植:过去的努力,目前的技术和未来的治疗潜力扩大

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摘要

Hepatic cell transplantation (HCT) continues to garner interest as an alternative to orthotopic liver transplantation and the attendant donor shortage. When compared with solid organ transplantation, advantages of cell transplantation include the potential to treat more patients with a considerably less invasive procedure, the ability to utilize organs otherwise unsuitable for transplant, and leaving the native organin situwith the potential for regeneration. While studies date back to the early 1960s, advancement of clinical application has been slow due in part to limitations of suitable tissue supplies and reproducible robust techniques. Compared with orthotopic liver transplantation, there are fewer absolute contraindications for donor selection. And, current techniques used to harvest, isolate, store, and even transfuse cells vary little between institutions. Significant variation is seen due to a lack of consensus with maintenance therapy. Although the ideal recipient has not been clearly identified, the most significant results have been demonstrated with correction of congenital metabolic liver disorders, with a few trials examining its utility in cirrhotics and more recently acute liver failure. The most exciting new topic of discussion examines techniques to improve engraftment, with many such as ischemic preconditioning and nonselective partial embolization (microbead therapy), while not yet used in HCT study, showing promise in solid organ research. Advancements in HCT, although slow in progress, have great potential in the ability to alleviate the burden faced in solid organ transplantation and possibly become a long-term viable option, beyond that of a bridge or salvage therapy.
机译:肝细胞移植(HCT)继续作为原位肝移植的替代品和随访捐助者短缺的替代品。与固体器官移植相比,细胞移植的优点包括治疗更多患者的潜力,患有相当更少的侵入性手术,利用器官不适合移植的能力,并将天然有机体出现的能力进行再生的潜力。虽然研究日期回到20世纪60年代初期,但临床应用的进步是由于合适的组织供应和可重复的鲁棒技术的限制而慢。与原位肝移植相比,供体选择的绝对禁忌症较少。并且,目前用于收获,隔离,储存,甚至输液单元的当前技术在机构之间不均匀。由于缺乏与维持治疗的共识,因此可以看到显着的变化。虽然理想的受体尚未明确识别,但已经证明了先天性代谢肝病的纠正,几次试验在肝脏和最近的急性肝功能下进行了一些试验。讨论最令人兴奋的新课题研究了改善植入的技术,许多如缺血性预处理和非选择性部分栓塞(微观疗法),而尚未用于HCT研究,展示了固体器官研究中的承诺。 HCT的进步虽然进入缓慢,但在缓解固体器官移植中面临的负担,并且可能成为一个长期可行的选择,超出了桥梁或抢救疗法的长期可行选择的能力有很大的潜力。

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