肾脏移植血管并发症指南  

Guidelines for vascular complications in kidney transplantation

作　　者：中华医学会器官移植学分会 欧彤文[2] 杨洪吉[3] 蒋亚梅 吴江涛[4] 黄莹[4] 王琦[4] 李广萍 邢添瑛 Branch of Organ Transplantation,Chinese Medical Association;Ou Tongwen;Yang Hongji(不详;Department of Urology,Xuanwu Hospital,Capital Medical University,Beijing 100053;Organ Transplantation Center,Sichuan Provincial People's Hospital,Chengdu 610072)

机构地区：[1]不详 [2]首都医科大学宣武医院泌尿外科,北京100053 [3]四川省人民医院器官移植中心,成都610072 [4]首都医科大学宣武医院

出　　处：《中华器官移植杂志》2025年第2期106-118,共13页Chinese Journal of Organ Transplantation

基　　金：首都卫生发展科研专项(2020-2-2015)。

摘　　要：随着器官移植技术的不断进步和完善,肾脏移植术后血管并发症的发生率相对较低,但一旦发生,可能会对移植肾功能造成严重影响,甚至导致移植失败。肾脏移植后血管并发症包括移植肾动脉血栓形成、移植肾静脉血栓形成、移植肾动脉破裂、移植肾血管扭转、移植肾动脉狭窄、移植肾静脉狭窄和移植肾动脉瘤等。在临床实践中,及时识别和准确诊断这些血管并发症是改善受者预后的关键。本文旨在总结肾脏移植术后血管并发症的临床表现、诊断方法和治疗方案。对于这些并发症的诊断,影像学检查如多普勒超声、计算机断层扫描血管成像(Computed tomography angiography,CTA)、磁共振血管造影(Magnetic resonance angiography,MRA)和数字减影血管造影(Digital subtraction angiography,DSA)等具有重要价值。在治疗方面,根据不同的并发症类型,可采取药物治疗、介入治疗或外科手术等多种方式。通过对这些肾脏移植后血管并发症的深入研究和总结,期望能给予临床医师面对这些复杂并发症时可以借鉴的经验,从而提高移植肾的存活率和受者的生存质量。With the continuous advancement of organ transplantation technology,the incidence of vascular complications following kidney transplantation remains relatively low.However,when these complications occur,they can significantly impair allograft function and may even lead to graft failure.Vascular complications after kidney transplantation include kidney graft artery thrombosis,kidney graft vein thrombosis,kidney graft artery rupture,vascular torsion,transplant kidney artery stenosis,transplant renal vein stenosis,and kidney graft artery aneurysm.Early identification and accurate diagnosis of these complications are crucial for optimizing patient outcomes.This guideline aims to summarize the clinical manifestations,diagnostic methods,and treatment strategies for vascular complications after kidney transplantation.Imaging modalities such as ultrasonography,computed tomography angiography(CTA),magnetic resonance angiography(MRA),and digital subtraction angiography(DSA)play a pivotal role in diagnosis.Treatment approaches vary based on the type of complication and may include pharmacological therapy,interventional procedures,or surgical intervention.To provide a standardized framework for managing these complex complications,the Organ Transplantation Branch of the Chinese Medical Association convened experts to develop the Chinese Guidelines for Vascular Complications in Kidney Transplantation.These guidelines serve as a valuable reference for clinicians,aiming to improve renal graft survival and enhance patient quality of life.

关 键 词：肾脏移植 移植后血管并发症 移植肾血栓形成 移植肾动脉破裂 移植肾血管扭转 移植肾动脉狭窄 移植肾动脉瘤 

分 类 号：R699.2[医药卫生—泌尿科学]