世界人口老龄化严重影响全球医疗保健，特别是移植领域。加上终末器官功能障碍和长期免疫抑制，年龄增加了移植候选者和接受者合并慢性疾病的频率，导致预后较差。尽管死亡频率随着年龄的增长而增加，但对已故老年捐献者器官的有限使用反映了对器官耐久性和功能不足的担忧。细胞衰老（CS）是衰老的一个标志，它是对无数细胞应激源的反应而发生的，导致信号级联激活，稳定地阻止细胞周期进程以防止肿瘤发生。在衰老和慢性疾病中，随着免疫系统清除衰老细胞的能力减弱，衰老细胞会不断积累，这与慢性疾病的进展、免疫功能障碍、器官损伤、再生能力下降和衰老本身有关。衰老细胞、其促炎分泌体和免疫细胞之间的密切相互作用导致正反馈循环，从而传播慢性无菌性炎症和 CS 的传播。因此，老年捐献者器官中的衰老细胞会触发受体的同种免疫反应，导致移植物丢失的风险增加。消除衰老细胞或减弱其炎症表型是一种新颖的、潜在的治疗目标，可以改善移植结果并扩大老年捐献者器官的利用。本综述重点介绍了在器官损伤和疾病进展的背景下 CS 对循环免疫细胞影响的最新知识，讨论了 CS 对常见移植的腹部实体器官的影响，并回顾了针对 CS 的新兴疗法。版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

Aging of the world population significantly impacts healthcare globally and specifically, the field of transplantation. Together with end-organ dysfunction and prolonged immunosuppression, age increases the frequency of comorbid chronic diseases in transplant candidates and recipients, contributing to inferior outcomes. Although the frequency of death increases with age, limited use of organs from older deceased donors reflects the concerns about organ durability and inadequate function. Cellular senescence (CS) is a hallmark of aging, which occurs in response to a myriad of cellular stressors, leading to activation of signaling cascades that stably arrest cell cycle progression to prevent tumorigenesis. In aging and chronic conditions, senescent cells accumulate as the immune system's ability to clear them wanes, which is causally implicated in the progression of chronic diseases, immune dysfunction, organ damage, decreased regenerative capacity, and aging itself. The intimate interplay between senescent cells, their proinflammatory secretome, and immune cells results in a positive feedback loop, propagating chronic sterile inflammation and the spread of CS. Hence, senescent cells in organs from older donors trigger the recipient's alloimmune response, resulting in the increased risk of graft loss. Eliminating senescent cells or attenuating their inflammatory phenotype is a novel, potential therapeutic target to improve transplant outcomes and expand utilization of organs from older donors. This review focuses on the current knowledge about the impact of CS on circulating immune cells in the context of organ damage and disease progression, discusses the impact of CS on abdominal solid organs that are commonly transplanted, and reviews emerging therapies that target CS.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.