中国ABO血型不相容活体亲属肾脏移植临床诊疗指南(2023版)

Chinese clinical practice guidelines for ABO-incompatible living donor kidney transplantation among relatives(edition 2023)

ABO血型不相容活体供者肾脏移植(ABO-incompatible living donor kidney transplantation,ABOi-LDKT)跨越了血型障碍,成为扩大供体库的主要措施之一。《ABO血型不相容活体亲属肾脏移植临床诊疗指南(2024版)》由中华医学会器官移植学分会组织编写。本指南在2017年版的基础上,通过构建临床问题,更新及总结现有文献证据,为ABOi-LDKT提供最佳治疗方案。其主要内容包括ABOi-LDKT适应证、HLA配型要求、血型抗体滴度的监测、处理方式及处理目标、术前凝血功能要求及是否抗凝、C4d的临床意义等。本指南的核心目标是向血型不相容活体供者和移植受者的临床医生提供最佳决策工具,以优化临床结果。本指南在亲属活体肾脏移植相关共识的基础上,关注由ABO血型不相容带来的独特问题及潜在风险。ABOi-LDKT必须关注近、远期可能出现的各种问题,这些问题必须向潜在的捐献者及受者说明,以便他们能够考虑在内,其最终目的是确保在向供者和受者提供高质量的研究证据和信息的基础上,让其充分知情的同意,从而做出合理的选择。

ABO-incompatible living donor kidney transplantation(ABOi-LDKT)has emerged as one of primary measures for expanding the pool of living donors through transcending blood type barriers."Clinical practice guidelines for abo-incompatible living donor kidney transplantation"were formulated under the auspices of Branch of Organ Transplantation,Chinese Medical Association.Based upon Edition 2017,this guideline was intended to provide optimal treatment protocols for ABOi-LDKT through structuring clinical queries,updating and synthesizing existing literature evidence.Its key contents encompassed indications for ABOi-LDKT,HLA matching requirements,monitoring of blood group antibody titers,treatment modalities and goals,preoperative coagulation function prerequisites and necessity of anticoagulation,as well as clinical significance of C4d.The core objective of this guideline was to furnish clinicians managing ABO-incompatible living donors and transplant recipients with the best decision-making tools for optimizing clinical outcomes.Grounded in the consensus of living related kidney transplantation,this guideline focused upon unique challenges and potential risks posed by ABO incompatibility.ABOi-LDKT necessitates a comprehensive consideration of both short/long-term complications and all concerns should be disclosed to potential donors and recipients for informing their decisions.Ultimately,both donors and recipients are provided with high-quality research evidence and information,facilitating fully informed consent and rational choices.