Coagulation dysfunction in liver xenotransplantation:from molecular incompatibility to organ-specific dysregulation
DOU Kefeng
ZHANG Xuan
ZHAO Liqiang
Abstract：With the development of gene-editing technologies,hyperacute rejection in xenotransplantation has been effectively controlled.However,coagulation dysfunction remains the principal bottleneck limiting the clinical translation of liver xenotransplantation.Coagulation abnormalities after liver xenotransplantation are characterized by early onset,coexistence of hypercoagulability and bleeding,and organ-specific features that are independent of classical immune rejection.The underlying mechanisms involve multiple pathways,including immune-mediated activation of coagulation,incompatibility of cross-species coagulation regulatory molecules,abnormal platelet activation and dysregulated phagocytosis,as well as the amplifying effects of the liver's unique structure and function.Current intervention strategies are centered on multi-gene editing of donor pigs,combined with integrated perioperative management of immunity,coagulation,and inflammation,which can partially ameliorate coagulation imbalance.This article systematically reviews the clinical features,molecular mechanisms,and intervention strategies of coagulation dysfunction in liver xenotransplantation,and further discusses future research directions,with the aim of providing a theoretical basis for advancing its clinical application.
Keywords：liver transplantationxenotransplantationcoagulation dysfunctionthrombocytopeniathrombotic microangiopathygene editinggraft rejectiondisease modelsanimal
Publication Date：2026-04-30
Online Publishing Date：2026-08-26(First online date of this platform, not the publication date of the document)
Pages：7( 469-475 )