[Current status and future prospects of complex liver transplantation]

Liver transplantation is the most effective treatment for end-stage liver disease. This article presents a review focusing on the research progress of complex liver transplantation. First, it analyzes two core clinical challenges currently restricting the development of liver transplantation: the shortage of donor liver resources and the increasing complexity of recipient conditions. Second, it categorically reviews the current development status of various complex liver transplantation techniques, sequentially elaborating on the technical key points, domestic innovative achievements, and clinical bottlenecks of non-whole graft liver transplantation (including living donor, auxiliary, autologous, split, and reduced-size liver transplantation), Domino multi-recipient liver transplantation, as well as cutting-edge new technologies such as combined organ transplantation, ischemia-free liver transplantation, and xenogeneic liver transplantation. The efficacy of each technique is summarized by integrating data from domestic and international literature. Finally, leveraging the advantage in the large volume of liver transplantation cases of China, the article summarizes multiple original technological breakthroughs in domestic complex liver transplantation and prospects the future development directions of the field from the perspectives of surgical technique optimization, individualized precise recipient management, donor liver resource coordination, and multidisciplinary collaboration, aiming to provide reference for the clinical diagnosis and treatment of complex liver transplantation and subsequent research.