当前正在研发新的移植技术以保护受损组织或器官的功能。尽管目前的技术可以增强受体的存活能力，但由于移植物被体内不需要的免疫反应所排斥，无论多么系统地应用免疫抑制剂，这一问题一直难以解决。由于现有药物需要终身免疫调节，且会产生严重不良反应，近年来，基于生物材料的免疫工程策略的发展引起了广泛关注。免疫调节的三维平台可以在局部改变免疫反应，或通过保护移植物免受免疫系统攻击来预防移植物排斥。这些新方法旨在克服长期使用全身免疫抑制剂的复杂性，包括感染风险、癌症发病率和全身毒性的风险。此外，它们可以通过在移植部位直接输送药物来减少有效剂量。在本综述中，我们全面讨论了免疫排斥机制，随后介绍了基于生物材料的免疫工程策略在延长移植物存活方面的最新进展。我们还将这些新平台与传统药物的功效和安全性进行了比较。最后，讨论了基于生物材料的免疫工程移植物的临床转化面临的挑战和障碍以及前景。版权所有 © 2023. Elsevier B.V. 发表。

Novel transplantation techniques are currently under development to preserve the function of impaired tissues or organs. While current technologies can enhance the survival of recipients, they have remained elusive to date due to graft rejection by undesired in vivo immune responses despite systemic prescription of immunosuppressants. The need for life-long immunomodulation and serious adverse effects of current medicines, the development of novel biomaterial-based immunoengineering strategies has attracted much attention lately. Immunomodulatory 3D platforms can alter immune responses locally and/or prevent transplant rejection through the protection of the graft from the attack of immune system. These new approaches aim to overcome the complexity of the long-term administration of systemic immunosuppressants, including the risks of infection, cancer incidence, and systemic toxicity. In addition, they can decrease the effective dose of the delivered drugs via direct delivery at the transplantation site. In this review, we comprehensively address the immune rejection mechanisms, followed by recent developments in biomaterial-based immunoengineering strategies to prolong transplant survival. We also compare the efficacy and safety of these new platforms with conventional agents. Finally, challenges and barriers for the clinical translation of the biomaterial-based immunoengineering transplants and prospects are discussed.Copyright © 2023. Published by Elsevier B.V.