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肝肾联合移植临床诊疗指南

中华医学会器官移植学分会, 孙煦勇, 蓝柳银, 等. 肝肾联合移植临床诊疗指南[J]. 器官移植. doi: 10.3969/j.issn.1674-7445.2024129
引用本文: 中华医学会器官移植学分会, 孙煦勇, 蓝柳银, 等. 肝肾联合移植临床诊疗指南[J]. 器官移植. doi: 10.3969/j.issn.1674-7445.2024129
Branch of Organ Transplantation of Chinese Medical Association, , , et al. Guidelines for clinical diagnosis and treatment of combined liver and kidney transplantation[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2024129
Citation: Branch of Organ Transplantation of Chinese Medical Association, , , et al. Guidelines for clinical diagnosis and treatment of combined liver and kidney transplantation[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2024129

肝肾联合移植临床诊疗指南

doi: 10.3969/j.issn.1674-7445.2024129
基金项目: 广西重点研发计划(桂科AB24010059)
详细信息
    通讯作者:

    孙煦勇,医学博士,主任医师,研究方向为移植医学,Email:sxywn@sohu.com

  • 中图分类号: R617, R692, R575

Guidelines for clinical diagnosis and treatment of combined liver and kidney transplantation

More Information
  • 摘要: 肝肾联合移植相继应用于各大移植中心,使许多终末期肝、肾衰竭患者重获新生。然而肝肾联合移植术的临床诊疗及长期生存预后仍存在较多需要解决的问题。本指南参考《肝肾联合移植技术操作规范(2019版)》和国内外已发表的最新文献和指南,制定了《肝肾联合移植临床诊疗指南》。就肝肾联合移植的手术指征和禁忌证、术前准备和评估、在终末期肝病和肾病中移植的时机、手术方法的选择以及术后随访、联合移植受者的独特病理生理学、外科技术、并发症管理和免疫抑制治疗的选择等临床问题提出推荐意见,以提高移植物利用率,改善肝肾联合移植受者的生存预后。

     

  • 表  1  证据质量与推荐强度分级

    Table  1.   Evidence quality and recommended intensity grades

    推荐强度 证据级别 描述
    A 1a 随机对照试验的系统评价
    1b 结果可信区间小的随机对照试验
    1c 显示“全或无效应”的任何证据
    B 2a 队列研究的系统评价
    2b 单个的队列研究(包括低质量的随机对照试验,如失访率>20%)
    2c 基于患者结局的研究
    3a 病例对照研究的系统评价
    3b 单个病例对照研究
    C 4 病例系列报告、低质量队列研究和低质量病例对照研究
    D 5 专家意见(即无临床研究支持的仅依据基础研究或临床经验的推测)
    下载: 导出CSV

    表  2  AKI的定义和分类

    Table  2.   Definition and classification of AKI

    AKI分级 血清肌酐标准 尿量标准
    1(危险) 48 h内增加≥18 μmol/L或较基线升高1.5~2.0倍 <0.5 mL/(kg·h)持续时间>6h
    2(损伤) 较基线升高1.5~2.0倍 <0.5 mL/(kg·h)持续时间>12 h
    3(衰竭) 较基线升高1.5~2.0倍或≥240 μmol/L伴Scr急性升高≥30 μmol/L,或开始肾脏替代治疗 <0.3 mL/(kg·h)持续24 h,或无尿12 h
    下载: 导出CSV
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  • 收稿日期:  2024-04-28
  • 网络出版日期:  2024-05-30

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