中国肝移植治疗不可切除结直肠癌肝转移临床实践指南(2023版)

Guideline for the clinical diagnosis and treatment of chronic injury of transplanted kidney(2023edition)

无法行根治性切除或达到无疾病证据(no evidence of disease, NED)状态的结直肠癌肝转移(colorectal liver metastases, CRLM)预后极差, 肝移植可能为这些患者带来新的治疗希望。为了推动国内高质量、规范化开展肝移植治疗不可切除的CRLM, 中华医学会器官移植学分会组织多学科专家以循证方法学和德尔菲法为指导, 围绕肝移植治疗策略下CRLM不可切除性的判定、受者筛选、生物侵袭性评估、肿瘤学治疗和免疫抑制方案以及应对供器官短缺和分配限制的策略进行文献检索、综述和证据综合, 经过两次线下会议讨论和两轮专家函询, 制定了《中国肝移植治疗不可切除结直肠癌肝转移临床实践指南(2023版)》, 为行业内医务人员提供借鉴和参考。

Chronic allograft injury(CAI)typically occurs in the medium to long-term stage after kidney transplantation,resulting in a gradual deterioration of the transplanted kidney's function and affecting long-term survival of the grafts and recipients.CAI has multiple etiologies with varying injuries that may intertwine,leading to complex clinical manifestations.This poses challenges for diagnosing and treating CAI effectively,making it an important clinical issue in the field of kidney transplantation.To protect the function of the transplanted kidney and enhance its long-term survival rate,the Chinese Medical Association of Organ Transplantation Branch initiated the development of the"Guideline for the Clinical Diagnosis and Treatment of Chronic Injury of Transplanted Kidney(2023 edition)".This guideline systematically summarizes CAI's etiologies,clinical diagnosis and differential diagnosis,treatment strategies,prognosis and follow-up plans while adhering to"Oxford University's 2009 Evidence Grading System"for recommendation strength grading standards.By establishing recommendation strength levels and evidence grades,this guideline provides guidance throughout all stages of clinical diagnosis and treatment.