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肾脏与膀胱移植:进展、障碍及新出现的解决方案

Kidney and Bladder Transplantation: Advances, Barriers, and Emerging Solutions.

作者信息

Kuttymuratov Gani, Saliev Timur, Ainakulov Ardak, Ayaganov Askar, Oshakbayev Kuat, Zharassov Daulet, Tuleuzhan Abdurakhman, Uderbayev Nurlybek

机构信息

Department of Multidisciplinary Surgery, University Medical Center, Nazarbayev University, Astana 010000, Kazakhstan.

Institute for Fundamental and Applied Medical Research, S.D. Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan.

出版信息

Medicina (Kaunas). 2025 Jun 5;61(6):1045. doi: 10.3390/medicina61061045.

Abstract

Urogenital transplantation has emerged as a ground-breaking field with the potential to revolutionize the treatment of end-stage organ failure and congenital or acquired defects of the kidney and urinary bladder. This review provides a comprehensive analysis of the current state, clinical experiences, and experimental progress in kidney and bladder transplantation, with a particular focus on immunological, surgical, and ethical challenges. While kidney transplantation is now a well-established procedure offering improved survival and quality of life for patients with chronic renal failure, bladder transplantation remains in the experimental phase, facing hurdles in vascularization, tissue integration, and functional restoration. Recent advancements in tissue engineering, regenerative medicine, and immunosuppressive strategies are critically discussed, highlighting their role in shaping the future of urogenital grafts. This review also explores xenotransplantation and bio-artificial organ development as promising frontiers. Continued interdisciplinary research is essential to overcome the current limitations and enable routine clinical application of bladder transplantation while optimizing outcomes in kidney grafts.

摘要

泌尿生殖系统移植已成为一个具有开创性的领域,有可能彻底改变终末期器官衰竭以及肾脏和膀胱先天性或后天性缺陷的治疗方法。本综述对肾脏和膀胱移植的现状、临床经验及实验进展进行了全面分析,特别关注免疫、外科和伦理方面的挑战。虽然肾脏移植如今已是一项成熟的手术,能改善慢性肾衰竭患者的生存率和生活质量,但膀胱移植仍处于实验阶段,在血管化、组织整合和功能恢复方面面临障碍。文中对组织工程、再生医学和免疫抑制策略的最新进展进行了批判性讨论,强调了它们在塑造泌尿生殖系统移植物未来中的作用。本综述还探讨了异种移植和生物人工器官的发展,将其视为有前景的前沿领域。持续的跨学科研究对于克服当前的局限性、实现膀胱移植的常规临床应用并优化肾脏移植的效果至关重要。

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