儿童肾脏移植排斥反应临床诊疗指南  

Clinical practice guidelines for the diagnosis and treatment of pediatric kidney transplant rejection reaction

作　　者：中华医学会器官移植学分会 丰贵文[2] 尚文俊[2] Branch of Organ Transplantation,Chinese Medical Association;Feng Guiwen;Shang Wenjun(不详;Department of Kidney Transplantation,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000)

机构地区：[1]不详 [2]郑州大学第一附属医院肾移植科,郑州450000

出　　处：《中华器官移植杂志》2025年第3期171-185,共15页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金(82270792、82370757);河南省医学科技攻关项目(192102310124);河南省卫健委医学科技攻关项目(SBGJ2020003045)。

摘　　要：排斥反应的预防与治疗是肾脏移植成功的基石。但儿童肾脏移植受者受疾病谱、免疫系统、免疫抑制剂药动学及药效学、药物耐受性和依从性等多种因素影响,排斥反应的发生率高于成人受者,是制约儿童肾脏移植效果且需重点关注的重大临床问题。为进一步提高我国儿童肾脏移植受者和移植肾存活率与诊疗技术水平,推动儿童肾脏移植学科的发展,该指南对儿童肾脏移植排斥反应的预防与治疗的主要问题如排斥反应的流行病学特点、影响因素、围手术期排斥反应的预防、免疫维持期排斥反应的预防进行系统提炼、归纳;对儿童肾移植排斥反应的诊断、排斥反应的监测与治疗进行详细解答。The prevention and management of rejection are fundamental to the success of kidney transplantation.However,pediatric kidney transplant recipients face a higher incidence of rejection compared to adults due to multiple factors,including differences in disease spectrum,immune system characteristics,the pharmacokinetics and pharmacodynamics of immunosuppressants,drug tolerability,and adherence.Rejection remains a major clinical challenge that significantly impacts pediatric kidney transplant outcomes and requires focused attention.To enhance the survival rates of pediatric kidney transplant recipients and renal allografts,improve diagnostic and therapeutic standards,and advance the field of pediatric kidney transplantation in China,this guideline systematically synthesizes key aspects of rejection prevention and treatment.It addresses critical topics such as the epidemiological characteristics of rejection,contributing factors,perioperative rejection prophylaxis,and preventive strategies during the immunosuppressive maintenance phase.Additionally,it provides comprehensive guidance on the diagnosis,monitoring,and treatment of renal allograft rejection in pediatric patients,offering evidence-based recommendations to optimize transplant outcomes.

关 键 词：儿童 肾移植 排斥反应 围手术期 供者特异性抗体 

分 类 号：R726.9[医药卫生—儿科]