中国肝移植受者代谢病管理专家共识(2015版)  

Expert consensus on management of metabolic diseases in Chinese liver transplant recipients( 2015 edition)

作　　者：郑树森[1] 徐骁[1] 沈恬[1] 汪恺[1] 庄莉[1] 王卓轶[1] 高峰[1] 

机构地区：[1]中国医师协会器官移植医师分会、中华医学会外科学分会器官移植学组、中华医学会器官移植学分会肝移植学组、浙江大学医学院附属第一医院肝胆胰外科卫生部多器官联合移植研究重点实验室、感染性疾病诊治协同创新中心

出　　处：《中华移植杂志（电子版）》2015年第3期103-107,共5页Chinese Journal of Transplantation(Electronic Edition)

基　　金：国家科技部传染病重大专项(2012ZX10002017);国家高技术研究发展计划(863计划)(2012AA020204);国家自然科学基金创新群体(81421062)

摘　　要：肝移植受者是罹患代谢病的高危人群。肝移植术后代谢病的发生与免疫抑制剂、心血管疾病、肾病、感染等关系密切,在很大程度上影响受者的长期存活。中国医师协会器官移植医师分会、中华医学会外科学分会器官移植学组、中华医学会器官移植学分会肝移植学组组织专家制定了《中国肝移植受者代谢病管理专家共识(2015版)》,旨在为中国肝移植受者术后代谢病的防治提供建议,以期改善受者的长期生存。代谢病以肥胖症、糖尿病、高血压病、高脂血症为典型特征。代谢病的防治应以改变饮食习惯和生活方式为基础,调整免疫抑制方案,并适当使用药物治疗。建议在保证移植肝功能的前提下将相关可能导致代谢病的免疫抑制剂减量,含霉酚酸酯的无激素及钙调神经磷酸酶抑制剂最小化方案对减少肝移植术后代谢病的发生有益。Liver transplant recipients are at high risk of metabolic diseases,which are closely associated with immunosuppressive regimens,cardiovascular diseases,renal dysfunction and infection,having significant influence on long-term survival of recipients. The expert consensus on management of metabolic diseases in Chinese liver transplant recipients（ 2015 edition） is composed by Chinese College of Transplant Doctors,Section of Organ Transplantation,Chinese Society of Surgery,Section of Liver Transplantation,Chinese Society of Organ Transplantation aimed at giving advices on the prophylaxis and treatment of metabolic diseases in the Chinese liver transplant recipients,and also improving longterm survival of recipients. Metabolic diseases are characterized by obesity, hyperglycemia,hypertension and hyperlipidemia. Management of metabolic diseases should be based on change of diet and lifestyle modification and combined with adjustment of immunosuppressive regimen and medical therapy. It is advised to reduce certain immunosuppressant that may contribute to metabolic disease on the premise of normal graft function,and the combined regimen of mycophenolate mofetil with no steroid and minimized calcineurin inhibitors is considered to be beneficial.

关 键 词：肝移植 代谢病 糖尿病 高血压病 高脂血症 免疫抑制剂 共识 

分 类 号：R657.3[医药卫生—外科学]