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人工肝治疗的临床实践与研究进展

韩涛 张倩

引用本文:
Citation:

人工肝治疗的临床实践与研究进展

DOI: 10.12449/JCH240201
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:韩涛负责构思与撰写文章并最终定稿;张倩协助撰写部分文稿。
详细信息
    通信作者:

    韩涛, hantaomd@126.com (ORCID: 0000-0003-4216-6968)

Clinical practice and research advances in artificial liver support therapy

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    Corresponding author: HAN Tao, hantaomd@126.com (ORCID: 0000-0003-4216-6968)
  • 摘要: 人工肝支持系统是治疗肝衰竭的重要方法之一,近年来非生物型人工肝在肝衰竭救治中的作用越来越受到认可,在非肝衰竭疾病中的应用也日益广泛。临床上需要综合多种因素,合理选择非生物型人工肝治疗的时机及模式,规范化、个体化、精准化治疗及不同模式的优化组合是人工肝临床应用的趋势。生物型人工肝有关种子细胞来源、生物反应器等关键技术不断完善,且部分已经进入临床试验阶段。尽管人工肝治疗的临床实践与研究已取得很大进展,但仍面临不少挑战。如何通过技术创新与优化组合进一步提高其疗效与安全性,如何通过高质量的临床试验获得更高级别循证医学证据,仍是目前亟需解决的难题。

     

  • [1] Liver Failure and Artificial Liver Group, Chinese Society of Infectious Diseases, Chinese Medical Association; Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.

    中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组. 肝衰竭诊治指南(2018年版)[J]. 临床肝胆病杂志, 2019, 35( 1): 38- 44. DOI: 10.3969/j.issn.1001-5256.2019.01.007.
    [2] Severe Liver Disease and Artificial Liver Group, Chinese Society of Hepatology, Chinese Medical Association. Expert consensus on clinical application of artificial liver and blood purification(2022 edition)[J]. J Clin Hepatol, 2022, 38( 4): 767- 775. DOI: 10.3969/j.issn.1001-5256.2022.04.007.

    中华医学会肝病学分会重型肝病与人工肝学组. 人工肝血液净化技术临床应用专家共识(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 4): 767- 775. DOI: 10.3969/j.issn.1001-5256.2022.04.007.
    [3] SALIBA F, BAÑARES R, LARSEN FS, et al. Artificial liver support in patients with liver failure: A modified DELPHI consensus of international experts[J]. Intensive Care Med, 2022, 48( 10): 1352- 1367. DOI: 10.1007/s00134-022-06802-1.
    [4] SARIN SK, CHOUDHURY A, SHARMA MK, et al. Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver(APASL): an update[J]. Hepatol Int, 2019, 13( 4): 353- 390. DOI: 10.1007/s12072-019-09946-3.
    [5] European Association for the Study of the Liver. EASL clinical practice guidelines on acute-on-chronic liver failure[J]. J Hepatol, 2023, 79( 2): 461- 491. DOI: 10.1016/j.jhep.2023.04.021.
    [6] BAJAJ JS, O’LEARY JG, LAI JC, et al. Acute-on-chronic liver failure clinical guidelines[J]. Am J Gastroenterol, 2022, 117( 2): 225- 252. DOI: 10.14309/ajg.0000000000001595.
    [7] European Association for the Study of the Liver. EASL clinical practical guidelines on the management of acute(fulminant) liver failure[J]. J Hepatol, 2017, 66( 5): 1047- 1081. DOI: 10.1016/j.jhep.2016.12.003. PMID: 28417882.
    [8] SHINGINA A, MUKHTAR N, WAKIM-FLEMING J, et al. Acute liver failure guidelines[J]. Am J Gastroenterol, 2023, 118( 7): 1128- 1153. DOI: 10.14309/ajg.0000000000002340.
    [9] Liver Failure and Artificial Liver Group, Branch of Infectious Diseases, Chinese Medical Association. Guideline for non-bioartificial liver support systems in treatment of liver failure: 2016 update[J]. Chin J Clin Infect Dis, 2016, 9( 2): 97- 103. DOI: 10.3760/cma.i.issn.1674-2397.2016.02.001.

    中华医学会感染病学分会肝衰竭与人工肝学组. 非生物型人工肝治疗肝衰竭指南(2016年版)[J]. 中华临床感染病杂志, 2016, 9( 2): 97- 103. DOI: 10.3760/cma.j.issn.1674-2397.2016.02.001.
    [10] LIU L, HAN T. Advances in the application of non-bioartificial liver in treatment of non-liver failure diseases[J]. J Clin Hepatol, 2020, 36( 9): 2115- 2118. DOI: 10.3969/j.issn.1001-5256.2020.09.047.

    刘磊, 韩涛. 非生物型人工肝在非肝衰竭疾病治疗中的应用进展[J]. 临床肝胆病杂志, 2020, 36( 9): 2115- 2118. DOI: 10.3969/j.issn.1001-5256.2020.09.047.
    [11] AGARWAL B, CAÑIZARES RB, SALIBA F, et al. Randomized, controlled clinical trial of the DIALIVE liver dialysis device versus standard of care in patients with acute-on- chronic liver failure[J]. J Hepatol, 2023, 79( 1): 79- 92. DOI: 10.1016/j.jhep.2023.03.013.
    [12] BALLESTER MP, ELSHABRAWI A, JALAN R. Extracorporeal liver support and liver transplantation for acute-on-chronic liver failure[J]. Liver Int, 2023. DOI: 10.1111/liv.15647.[ Online ahead of print]
    [13] NICOLAS CT, HICKEY RD, CHEN HS, et al. Concise review: Liver regenerative medicine: From hepatocyte transplantation to bioartificial livers and bioengineered grafts[J]. Stem Cells, 2017, 35( 1): 42- 50. DOI: 10.1002/stem.2500.
    [14] DUAN ZP, XIN SJ, ZHANG J, et al. Comparison of extracorporeal cellular therapy(ELAD®) vs standard of care in a randomized controlled clinical trial in treating Chinese subjects with acute-on-chronic liver failure[J]. Hepat Med, 2018, 10: 139- 152. DOI: 10.2147/HMER.S180246.
    [15] LI LJ, DU WB, ZHANG YM, et al. Evaluation of a bioartificial liver based on a nonwoven fabric bioreactor with porcine hepatocytes in pigs[J]. J Hepatol, 2006, 44( 2): 317- 324. DOI: 10.1016/j.jhep.2005.08.006.
    [16] LI WJ, ZHU XJ, YUAN TJ, et al. An extracorporeal bioartificial liver embedded with 3D-layered human liver progenitor-like cells relieves acute liver failure in pigs[J]. Sci Transl Med, 2020, 12( 551): eaba5146. DOI: 10.1126/scitranslmed.aba5146.
    [17] SHI XL, GAO YM, YAN YP, et al. Improved survival of porcine acute liver failure by a bioartificial liver device implanted with induced human functional hepatocytes[J]. Cell Res, 2016, 26( 2): 206- 216. DOI: 10.1038/cr.2016.6.
    [18] WANG Y, ZHENG Q, SUN Z, et al. Reversal of liver failure using a bioartificial liver device implanted with clinical-grade human-induced hepatocytes[J]. Cell Stem Cell, 2023, 30( 5): 617- 631. DOI: 10.1016/j.stem.2023.03.013.
    [19] CHEN HS, JOO DJ, SHAHEEN M, et al. Randomized trial of spheroid reservoir bioartificial liver in porcine model of posthepatectomy liver failure[J]. Hepatology, 2019, 69( 1): 329- 342. DOI: 10.1002/hep.30184.
    [20] WENG J, HAN X, ZENG FH, et al. Fiber scaffold bioartificial liver therapy relieves acute liver failure and extrahepatic organ injury in pigs[J]. Theranostics, 2021, 11( 16): 7620- 7639. DOI: 10.7150/thno.58515.
    [21] FENG L, WANG Y, FU Y, et al. A simple and efficient strategy for cell-based and cell-free-based therapies in acute liver failure: hUCMSCs bioartificial liver[J]. Bioeng Transl Med, 2023, 8( 5): e10552. DOI: 10.1002/btm2.10552.
    [22] WANG J, REN H, LIU Y, et al. Bioinspired artificial liver system with hiPSC-derived hepatocytes for acute liver failure treatment[J]. Adv Healthc Mater, 2021, 10( 23): e2101580. DOI: 10.1002/adhm.202101580.
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  • 收稿日期:  2023-11-20
  • 录用日期:  2023-12-20
  • 出版日期:  2024-02-19
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