移植肾慢性损害临床诊疗指南(2023版)

Clinical practice guidelines on liver transplantation for nonresectable liver-only colorectal liver metastases in China (2023 edition)

移植肾慢性损害(chronic allograft injury, CAI)一般在肾脏移植后的中长期阶段出现, 导致移植肾脏功能逐渐下降, 影响移植肾和受者的长期存活。CAI存在多种不同病因, 可能相互交织, 临床表现复杂, 这些特点给CAI的诊断和治疗带来挑战。因此, 如何有效应对CAI是肾脏移植领域中的重要临床问题。为了保护移植肾功能, 提高移植肾长期存活率, 中华医学会器官移植学分会发起并制订了《移植肾慢性损害临床诊疗指南(2023版)》, 本指南系统总结CAI的病因、临床诊断和鉴别诊断、治疗策略、预后和随访方案, 采用2009牛津大学证据分级与推荐意见强度分级标准, 制定推荐强度和证据等级, 为临床诊疗全过程提供参考。

The prognosis is notably grim for patients with colorectal liver metastases(CRLM)ineligible for curative resection or achieving a status of no evidence of disease(NED).In this context,liver transplantation emerges as a great beacon of hope.To foster the adoption of high-quality standardized liver transplantation practices for unresectable CRLM across China,Branch of Organ Transplant of Chinese Medical Association has convened a panel of multidisciplinary experts and drafted this guideline after two offline meetings and two rounds of expert inquiries guided by evidence-based methodologies and Delphi process.This guideline focused upon criteria for judging CRLM non-resectability within the context of liver transplantation,selection of candidates,evaluation of tumor aggressiveness,oncological treatment strategies,immunosuppression protocols and tactics for navigating donor scarcity and allocation challenges.It served as a valuable resource and standard for healthcare practitioners in the field.