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中华普通外科学文献(电子版) ›› 2026, Vol. 20 ›› Issue (02) : 133 -137. doi: 10.3877/cma.j.issn.1674-0793.2026.02.011

综述

成人肝移植中大肝综合征的诊疗进展
艾孜曼提·艾山江1, 阿力木·土拉宏1, 郭强1, 张瑞青1, 阿卜杜海外尔·阿卜杜合力力1, 吐尔干艾力·阿吉1,2,()   
  1. 1 830013 乌鲁木齐,新疆医科大学第一附属医院消化血管外科中心肝胆包虫病外科
    2 830013 乌鲁木齐,新疆医科大学省部共建中亚高发病成因与防治国家重点实验室
  • 收稿日期:2025-09-08 出版日期:2026-04-01
  • 通信作者: 吐尔干艾力·阿吉
  • 基金资助:
    “天山英才”培养计划科技创新领导人才项目——高层次领导人才(2022TSYCLJ0034)

Progress in the diagnosis and treatment of large-for-size liver syndrome in adult liver transplantation

·Aishanjiang Aizimanti1, ·Tulahong Alimu1, Qiang Guo1, Ruiqing Zhang1, ·Abduheli Abuduhaiwai’er1, ·Aji Turganaili1,2,()   

  1. 1 Hepatobiliary Echinococcosis Surgery, Center for Digestive and Vascular Surgery, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830013, China
    2 State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Medical University, Urumqi 830013, China
  • Received:2025-09-08 Published:2026-04-01
  • Corresponding author: ·Aji Turganaili
引用本文:

艾孜曼提·艾山江, 阿力木·土拉宏, 郭强, 张瑞青, 阿卜杜海外尔·阿卜杜合力力, 吐尔干艾力·阿吉. 成人肝移植中大肝综合征的诊疗进展[J/OL]. 中华普通外科学文献(电子版), 2026, 20(02): 133-137.

·Aishanjiang Aizimanti, ·Tulahong Alimu, Qiang Guo, Ruiqing Zhang, ·Abduheli Abuduhaiwai’er, ·Aji Turganaili. Progress in the diagnosis and treatment of large-for-size liver syndrome in adult liver transplantation[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2026, 20(02): 133-137.

肝移植历经60余年发展,其技术体系和临床理念日臻成熟,现已成为终末期肝病的标准化治疗手段。值得注意的是,成人肝移植中移植物-受体体积失配引发的大肝综合征仍是制约移植疗效的重大挑战之一。精准的术前评估、合理的手术规划及针对性的术中干预,是防控此类并发症的关键环节。随着病理机制研究的深入,延迟腹膜闭合、移植物减容、门静脉血流调控等针对性干预策略不断完善。增强现实、虚拟现实、三维打印及人工智能等创新手段的应用,更为术前评估和规划提供了多模态可视化支持。本文通过系统综述成人肝移植中大肝综合征的核心机制研究进展,系统归纳各类新技术在肝移植手术中的创新应用,以期为改善肝移植临床预后提供理论支撑及技术路线参考。

Over the past six decades, liver transplantation has witnessed continuous advancements in its technical system and clinical concepts, and has now become standardized treatment for end-stage liver disease. Notably, large-for-size liver syndrome (LFSS) caused by graft-recipient size mismatch remains one of the major challenges restricting the efficacy of adult liver transplantation. Accurate preoperative assessment, rational surgical planning, and targeted intraoperative intervention are key links in preventing and controlling this complication. With the in-depth study of its pathological mechanism, targeted intervention strategies such as delayed abdominal closure, graft volume reduction, and portal blood flow regulation have been constantly improved. The application of innovative technologies including augmented reality, virtual reality, three-dimensional printing, and artificial intelligence further provides multi-modal visual support for preoperative assessment and planning. This article systematically reviews the research progress on the core mechanism of LFSS and summarizes the innovative application of various new technologies in liver transplantation surgery, aiming to provide theoretical support and technical route reference for improving the clinical prognosis of liver transplantation.

表1 肝移植中供体-受体大小不匹配相关的结果及机制分析
表2 小儿肝移植中大肝综合征的预防策略
表3 成人肝移植中大肝综合征的预防策略
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