离体肝切除联合自体肝移植（ELRA）作为一种突破性技术，为传统肝切除术难以处理的复杂肝脏疾病提供了根治性解决方案。本文系统综述了ELRA的适应证、关键技术及临床疗效。该技术通过离体低温灌注、精准病灶切除及血管重建，显著扩展了侵犯肝门、肝静脉或下腔静脉的良恶性疾病（如肝泡型棘球蚴病、肝细胞癌、胆管癌）的手术适应证，并避免了同种异体肝移植的供体短缺与免疫抑制风险。术前三维重建与功能性肝体积评估、术中无静脉-静脉旁路术的应用及流出道重建策略，有效提升了手术安全性；术后通过抗凝治疗与并发症监测（如肝静脉梗阻、胆道狭窄），降低了死亡率与严重并发症发生率。研究显示，ELRA在良性病变患者中1年生存率达89.7%，终末期肝泡型棘球蚴病患者的5年生存率>80%，显著优于非手术治疗。未来，随着人工智能导航、微创技术及新型器官保存液的发展，ELRA有望进一步优化，成为复杂肝胆疾病治疗的标准手段。

Ex vivo liver resection and autotransplantation (ELRA) represents a pioneering technique that provides a curative solution for complex hepatic diseases untreatable by conventional hepatectomy. This article systematically reviews the indications, key techniques, and clinical outcomes of ELRA. By utilizing ex vivo hypothermic perfusion, precision lesion resection, and vascular reconstruction, ELRA significantly expands surgical indications for benign and malignant diseases, such as hepatic alveolar echinococcosis (AE), hepatocellular carcinoma, and cholangiocarcinoma involving the hepatic hilum, hepatic veins or inferior vena cava, while avoiding donor shortages and immunosuppressive risks associated with allogeneic liver transplantation. Preoperative three-dimensional reconstruction and functional liver volume assessment, combined with intraoperative venous bypass-free techniques and outflow reconstruction strategies, enhance procedural safety. Postoperative anticoagulation therapy and monitoring of complications such as hepatic venous obstruction and biliary stricture, reduce mortality and severe morbidity. Studies demonstrated that ELRA achieved a 1-year survival rate of 89.7% in benign lesions and a >80% 5-year survival rate in end-stage hepatic AE, significantly outperforming non-surgical approaches. Future advancements in artificial intelligence navigation, minimally invasive techniques, and novel organ preservation solutions, may further optimize ELRA, establishing it as a standard intervention for complex hepatobiliary diseases.