成人供肾双肾移植临床应用指南(2023版)

Clinical guidelines for dural kidney transplantation using adult donor kidneys(2023 edition)

移植扩大标准供者(expanded criteria donor,ECD)捐献的肾脏是缓解器官短缺的重要途径之一。ECD供肾功能通常存在相对不足,移植单个供肾可能不足以满足受者的需求进而影响移植效果。将来自同一供者的两个ECD供肾同时移植给一个受者[即双肾移植(dural kidney transplantation,DKT)]为解决这一问题提供了可行方案。为提高ECD供肾利用率及DKT的成功率,保障DKT的临床效果,中华医学会器官移植学分会组织了国内肾脏移植领域相关专家,采用牛津证据质量与推荐强度分级体系,针对成人供肾DKT相关的供肾评估、受者筛选、手术方式、外科并发症、临床疗效等方面的12个临床问题,给出了较为详细的循证医学推荐,旨在指导临床实践,提升我国DKT水平,减少器官弃用率,缓解器官短缺。

Transplanting kidney from expanded criteria donors(ECD)is one of the important modes of alleviating the shortage of kidney organs.ECD kidney function is usually relatively insufficient and transplantation of a single ECD kidney may not be enough to fulfill the recipient's demand for kidney function,thus affecting the transplantation outcomes.Simultaneous transplantation of two ECD kidneys from the same donor to one recipient(dual kidney transplantation,DKT)provides a feasible solution to this problem.To improve the utilization rate of ECD kidneys and the success rate of DKT and optimize the clinical outcomes of DKT,the Organ Transplantation Society of Chinese Medical Association organized a panel of domestic experts in the field of kidney transplantation to provide detailed evidence-based medical recommendations for twelve common issues related to DKT using adult kidneys.The topics focused upon donor kidney evaluations,recipient screening,surgical options and complications and clinical outcomes,etc.The recommendations were based upon the"Oxford Grading System for Evidence Level and Recommendation Assessment".The goals were guiding clinical practices,improving the DKT level in China,promoting the application of ECD kidneys by DKT,lowering organ discard rate and alleviating organ shortage.