再生医学在治疗终末期肝病中的临床应用

Clinical Application of Regenerative Medicine in the Treatment of End-Stage Liver Diseases

摘要: 感染、代谢紊乱、酗酒、恶性肿瘤等急慢性损伤均可导致终末期肝病(end-stage liver disease, ESLD)的发生。迄今为止，肝移植仍是治疗ESLD唯一被证实的有效手段。然而由于供体数量严重短缺，肝移植在临床中开展受到了极大限制，许多患者在等待器官过程中由于疾病进展而错失肝移植机会甚至死亡。因此，在临床中如何改善ESLD患者肝功能具有重要意义。再生医学作为组织工程和分子生物学转化研究的一个分支，旨在通过临床医学、材料科学及生命科学等前沿交叉领域对人体各种组织器官功能进行替代、修复甚至重建。肝脏作为哺乳动物体内唯一具有再生能力的内脏器官，在经历大部分切除(75%)后仍能基本恢复至原有功能从而满足机体代谢需求。正因其具有如此巨大的再生能力让肝脏在再生医学领域备受关注。肝脏再生医学主要包括自身组织再生、细胞疗法以及组织工程三个方面，本文将对近年来上述技术在治疗肝脏疾病中的临床应用进行综述。

Abstract: Acute and chronic damage such as infection, metabolic disorders, alcohol abuse, and malignant tu-mors can lead to the occurrence of end-stage liver disease (ESLD). Liver transplantation is still the only proven effective treatment for ESLD. However, due to the severe shortage of donor numbers, the clinical development of liver transplantation has been greatly limited. Many patients miss the opportunity of liver transplantation or even die due to disease progression while waiting for the donors. Therefore, how to improve liver function of ESLD patients is of great clinical significance. As a branch of tissue engineering and molecular biology transformation research, regenerative medi-cine aims to replace, repair and even reconstruct various tissues and organs in the human body through cutting-edge fields such as clinical medicine, materials science and life sciences. The liver, as the only regenerative visceral organ in the mammal, can still recover to its original function after subtotal hepatectomy (75%) to meet the metabolic needs of the body. Because of its huge regener-ative capacity, the liver has attracted much attention in the field of regenerative medicine. Liver regenerative medicine mainly includes three main aspects: self-regeneration, cell therapy and tis-sue engineering. This paper will review the clinical application of the above techniques in the treatment of liver diseases in recent years.