2025年中国肾移植领域研究大盘点

Research highlights on kidney transplantation in 2025 from China

  • 摘要: 肾移植是治疗终末期肾病的首选方案,但供器官短缺、移植物损伤及排斥反应仍是制约其长期疗效的瓶颈。2025年,肾移植领域在基础与临床研究方面均取得了突破性进展。在供者来源拓展方面,多基因编辑猪异种移植在非人灵长类模型中实现长效存活,酶转化法构建“通用O型供肾”更是打破了ABO血型不相容移植的壁垒。在移植物损伤机制与保护方面,研究深入揭示了缺血-再灌注损伤中核磷酸蛋白1乳酸化驱动铁死亡及代谢重编程的分子机制,并开发了基于纳米载体与间充质干细胞外泌体的精准干预策略。在排斥反应诊疗方面,单细胞转录组测序精细绘制了包含Isg15+巨噬细胞在内的免疫应答图谱,功能性MRI与靶向成纤维细胞活化蛋白分子影像技术显著提升了排斥反应的无创监测效能。此外,基于药物基因组学的个体化免疫抑制方案及针对各类并发症的综合防治策略,进一步优化了受者的全生命周期管理。本文对2025年我国团队在肾移植领域相关的研究进展进行系统梳理和阐述,旨在为临床实践及未来科研方向提供参考。

     

    Abstract: Kidney transplantation is the first-line treatment for end-stage renal disease. However, the shortage of donor organs, graft injury and rejection remain major bottlenecks restricting its long-term efficacy. In 2025, breakthrough advances have been achieved in both basic and clinical research in the field of kidney transplantation. In terms of expanding donor sources, multi-gene-edited porcine xenotransplantation have achieved long-term survival in non-human primate models, and the construction of "universal type O donor kidneys" via enzymatic conversion has broken through the barrier of ABO-incompatible transplantation. Regarding the mechanisms and protection of graft injury, studies have deeply elucidated the molecular mechanism by which lactylation of nucleophosmin 1 drives ferroptosis and metabolic reprogramming during ischemia-reperfusion injury, and precise intervention strategies based on nanocarriers and mesenchymal stem cell-derived exosomes have been developed. In the diagnosis and treatment of rejection, single-cell RNA sequencing has finely mapped the immune response landscape including Isg15+ macrophages, and functional MRI as well as molecular imaging targeting fibroblast activation protein have significantly improved the efficacy of non-invasive monitoring of rejection. In addition, individualized immunosuppressive regimens based on pharmacogenomics and comprehensive prevention and treatment strategies for various complications have further optimized the whole-life-cycle management of transplant recipients. This article systematically reviews and summarizes the research progress made by Chinese teams in renal transplantation in 2025, aiming to provide references for clinical practice and future research directions.

     

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