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摘要: 结直肠癌是中国常见的恶性肿瘤之一，有研究显示超过50%的结直肠癌患者会发生转移，对于可切除的结直肠癌患者术后辅以系统治疗后有较好的5年生存率，然而对于不可切除的结直肠癌肝转移患者预后往往很差。尽管目前随着医疗的进步，如采取介入联合靶向和免疫治疗等多种方式治疗不可切除结直肠癌肝转移患者，但效果仍然不佳，因此部分临床研究人员将目光转移到了肝移植上。肝移植作为近年来兴起的治疗方式，有望改善不可切除结直肠癌肝转移患者的预后，本文就肝移植治疗不可切除结直肠癌肝转移这一方向做一论述，主要包括肝移植治疗结直肠癌肝转移的历史概况、近期结果、预后因素、适应标准、与系统治疗的关系以及肝源短缺和供者分配等问题，旨在为结直肠癌肝转移患者的肝移植治疗提供参考。Abstract: Colorectal cancer is one of the common malignant tumors in China. Studies have shown that more than 50% of patients with colorectal cancer will experience metastasis. After systematic treatment, patients with resectable colorectal cancer could obtain favorable 5-year survival rate. However, patients with unresectable colorectal liver metastasis constantly obtain poor prognosis. In spite of the development of medical treatment, patients with unresectable colorectal liver metastasis can be treated by multiple approaches, such as interventional therapy combined with targeted therapy and immunotherapy, clinical efficacy is relatively low. Hence, clinicians divert extensive attention to liver transplantation. Liver transplantation, as an emerging treatment in recent years, is expected to improve clinical prognosis of patients with unresectable colorectal liver metastasis. In this article, research progress in liver transplantation for patients with unresectable colorectal liver metastasis was reviewed, mainly including the historical overview, recent results, prognostic factors, adaptation criteria, relationship with systemic treatment, liver source shortage and donor allocation, aiming to provide reference for liver transplantation for patients with colorectal liver metastasis.
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