肝肾联合移植临床诊疗指南  

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

作　　者：中华医学会器官移植学分会 孙煦勇 蓝柳根[2] 文宁 董建辉 吴基华[2] Branch of Organ Transplantation of Chinese Medical Association;Sun Xuyong(不详;The Second Affiliated Hospital of Guangxi Medical University,Nanning 530007,China)

机构地区：[1]不详 [2]广西医科大学第二附属医院,南宁530007

出　　处：《器官移植》2024年第4期533-547,共15页Organ Transplantation

基　　金：广西重点研发计划(桂科AB24010059)。

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。Combined liver and kidney transplantation has been steadily applied in major transplantation centers,saving the lives of many patients with end-stage liver and renal failure.However,there are still multiple unresolved problems in the clinical diagnosis,treatment and long-term prognosis of combined liver and kidney transplantation.By referring to"Technical Operating Standards for Combined Liver and Kidney Transplantation(2019 Edition)"and the latest published literature and guidelines at home and abroad,"Guidelines for Clinical Diagnosis and Treatment of Combined Liver and Kidney Transplantation"was formulated.Recommendations and suggestions were delivered regarding the surgical indications and contraindications,preoperative preparation and evaluation,the timing of transplantation for endstage liver and kidney diseases,the selection of surgical approaches and postoperative follow-up,specific pathophysiology,surgical techniques,complication management and immunosuppressive treatment of combined live and kidney transplantation,aiming to enhance the utilization rate of grafts and improve the survival and prognosis of combined liver and kidney transplant recipients.

关 键 词：肝肾联合移植 肝移植 肾移植 排斥反应 免疫抑制药 术前评估 术后并发症 围手术期管理 

分 类 号：R617[医药卫生—外科学] R692[医药卫生—临床医学] R575