2025年的肺移植：对进展、挑战和未来道路的叙述性回顾
Lung transplantation in 2025: a narrative review of progress, challenges, and the road ahead.
摘要(中文译文)
肺移植（LTx）仍然是终末期肺病唯一的确切治疗方法。在整个2025年，全球移植界在应对该领域持续存在的挑战方面取得了显著进展，从移植物分配的政策层面改善到对移植后并发症更深入的生物学认识。本综述旨在综合2025年发表的关键文献，涵盖四个核心领域：优化分配、推进围手术期管理、明确移植物损伤机制以及探索转化前沿。我们进行了结构化文献检索，主要聚焦于2025年发表、突出肺移植重大进展的研究。此外，检索还补充了重要的学会指南、共识声明以及2026年初的相关出版物。所选文章经批判性分析后，分为临床进展和基础/转化研究发现。在临床研究中，分配策略的完善和供者标准的扩展有效拓宽了可及性。围手术期管理随着人工智能的整合而不断发展，用于预测原发性移植物功能障碍（PGD）和慢性肺移植物功能障碍（CLAD）等并发症。在基础和转化研究中，各项研究剖析了并发症的分子基础。此外，关于耐药病原体演变和巨噬细胞可塑性的新见解加深了我们对感染和排斥反应的理解。2025年，肺移植研究领域取得了重大进展。临床供者分配和围手术期管理策略，以及对并发症分子机制的理解，也得到了极大提升。这些进展对于进一步优化结局和应对肺移植中的复杂挑战至关重要。
Abstract
Lung transplantation (LTx) remains the only definitive treatment for end-stage lung disease. Throughout 2025, the global transplant community has made notable progress in addressing persistent challenges in the field, ranging from policy-level improvements in graft allocation to deeper biological insights into post-transplant complications. This review aims to synthesize the pivotal literature published in 2025 across four core areas: optimizing allocation, advancing perioperative care, defining the mechanisms of graft injury, and exploring translational frontiers. We conducted a structured literature search focused primarily on studies published in 2025 that highlight major advancements in LTx. In addition, the search was supplemented with key society guidelines, consensus statements, and relevant early 2026 publications. Selected articles were critically analyzed and categorized into clinical advancements, and basic/translational findings. In clinical research, the refinement of allocation strategies and the expansion of donor criteria, have effectively broadened access. Perioperative management has evolved with the integration of artificial intelligence to predict complications such as primary graft dysfunction (PGD) and chronic lung allograft dysfunction (CLAD). In basic and translational research, studies have dissected the molecular basis of complications. Additionally, new insights into the evolution of drug-resistant pathogens and macrophage plasticity have deepened our understanding of infection and rejection. In 2025, significant progress has been achieved in the field of LTx research. Strategies for clinical donor allocation and perioperative management, along with the understanding of molecular mechanisms underlying complications, have also been greatly improved. These advancements are essential to further optimize outcomes and address the complex challenges in LTx.
如何引用
AMA
Xiaohan Jin, Jiaqi Li, Yaling Liu, Audrey Yaulap Li, Jier Ma, Linxi Liu, et al. Lung transplantation in 2025: a narrative review of progress, challenges, and the road ahead.. Journal of thoracic disease. 2026; doi:10.21037/jtd-2026-0554.
APA
Xiaohan Jin, Jiaqi Li, Yaling Liu, Audrey Yaulap Li, Jier Ma, Linxi Liu, et al (2026). Lung transplantation in 2025: a narrative review of progress, challenges, and the road ahead.. Journal of thoracic disease. https://doi.org/10.21037/jtd-2026-0554
GB/T 7714
Xiaohan Jin, Jiaqi Li, Yaling Liu, Audrey Yaulap Li, Jier Ma, Linxi Liu, et al. Lung transplantation in 2025: a narrative review of progress, challenges, and the road ahead.[J]. Journal of thoracic disease, 2026 doi:10.21037/jtd-2026-0554.
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