肝移植术后急性排斥反应的无创检测手段进展

Progress in non-invasive detection of acute rejection after liver transplantation

  • 摘要: 肝移植是治疗终末期肝病及原发性肝癌的重要手段,而急性排斥反应仍然是影响受者预后的重要因素。目前,急性排斥反应的诊断主要依赖肝脏穿刺活组织检查,但其具有创伤性且存在诊断误差。无创检测手段如超声弹性成像、细胞因子检测等可辅助急性排斥反应诊断,但单一方法尚不能完全替代肝脏穿刺活组织检查,联合不同检测手段来综合预测和诊断肝移植术后排斥反应可能是未来研究的方向和趋势。因此,本文就肝移植术后急性排斥反应的无创检测手段,包括影像学评估及各种生物标志物进行综述,以期实现个体化免疫抑制管理,改善肝移植受者预后。

     

    Abstract: Liver transplantation is a key treatment for end-stage liver disease and primary liver cancer, yet acute rejection remains a major factor affecting the prognosis of recipients. At present, the diagnosis of acute rejection mainly relies on liver biopsy, but it is traumatic and has diagnostic errors. Non-invasive detection methods such as ultrasound elastography and cytokine assays can assist in the diagnosis of acute rejection, but a single method cannot completely replace liver biopsy. Combining multiple non-invasive methods to predict and diagnose rejection after liver transplantation is likely the direction of future research. Therefore, this article reviews non-invasive approaches for acute rejection after liver transplantation, including imaging evaluation and various biomarkers, in order to achieve personalized immunosuppressive management and improve the prognosis of liver transplant recipients.

     

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