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中国肾脏移植受者移植物功能延迟恢复临床诊疗指南

中华医学会器官移植学分会, 中国医疗保健国际交流促进会肾脏移植学分会, 项和立, 等. 中国肾脏移植受者移植物功能延迟恢复临床诊疗指南[J]. 器官移植. doi: 10.3969/j.issn.1674-7445.2024156
引用本文: 中华医学会器官移植学分会, 中国医疗保健国际交流促进会肾脏移植学分会, 项和立, 等. 中国肾脏移植受者移植物功能延迟恢复临床诊疗指南[J]. 器官移植. doi: 10.3969/j.issn.1674-7445.2024156
Branch of Organ Transplantation of Chinese Medical Association, Branch of Kidney Transplantation of China International Exchange and Promotive Association for Medical and Health Care, , et al. Guidelines for clinical diagnosis and treatment of delayed graft function in kidney transplant recipients in China[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2024156
Citation: Branch of Organ Transplantation of Chinese Medical Association, Branch of Kidney Transplantation of China International Exchange and Promotive Association for Medical and Health Care, , et al. Guidelines for clinical diagnosis and treatment of delayed graft function in kidney transplant recipients in China[J]. ORGAN TRANSPLANTATION. doi: 10.3969/j.issn.1674-7445.2024156

中国肾脏移植受者移植物功能延迟恢复临床诊疗指南

doi: 10.3969/j.issn.1674-7445.2024156
基金项目: 国家自然科学基金(82370802);陕西省卫生健康肾脏移植科研创新平台(2023PT-06)
详细信息
    通讯作者:

    薛武军,Email:xwujun126@xjtu.edu.cn

  • 中图分类号: R617, R692

Guidelines for clinical diagnosis and treatment of delayed graft function in kidney transplant recipients in China

More Information
  • 摘要: 肾移植受者移植物功能延迟恢复是肾脏移植术后常见的早期并发症之一,是影响移植肾近期和远期存活的独立危险因素。中华医学会器官移植学分会和中国医疗保健国际交流促进会肾脏移植学分会组织国内器官移植与相关学科知名专家在《肾移植术后移植物功能延迟恢复诊疗技术规范(2019版)》的基础上经过指南范围及临床问题的确定、证据检索与筛选及推荐意见的形成等程序编写、多轮讨论,并经学会组织两轮集体审定,最终形成《中国肾脏移植受者移植物功能延迟恢复临床诊疗指南》。本指南就移植肾功能延迟恢复的概念和发生机制、危险因素、诊断、预防、治疗及免疫抑制药应用几个方面的21个临床问题提出推荐意见和推荐意见说明。目的是使肾移植术后受者移植物功能延迟恢复的诊断、预防和治疗规范化,提高肾脏移植效果,提高肾脏移植受者和移植肾近期和长期存活率,促进移植学科的发展。

     

  • 表  1  2009牛津大学证据分级与推荐意见强度分级标准

    Table  1.   Level of evidence and recommended strength grades of Oxford University in 2009

    推荐强度证据等级描述
    A1aRCT的系统评价
    1b结果可信区间小的RCT
    1c显示“全或无效应”的任何证据
    B2a队列研究的系统评价
    2b单个队列研究(包括低质量的RCT,
    如失访率>20%者)
    2c基于受者结局的研究
    3a病例对照研究的系统评价
    3b单个病例对照研究
    C4病例系列报告、低质量队列研究和
    低质量病例对照研究
    D5专家意见(即无临床研究支持的仅依据
    基础研究或临床经验的推测)
    下载: 导出CSV

    表  2  美国器官共享联合网络制定的器官维护目标

    Table  2.   Organ maintenance goals set by the United States Organ Sharing Network

    指标 维护目标
    平均动脉压 60~110 mmHg
    中心静脉压 4~12 mmHg
    射血分数 >50%
    低剂量血管升压类药物 种类≤1种。低剂量:多巴胺<10 μg/(kg·min),去氧肾上腺素<1 μg/(kg·min),去甲肾上腺素<0.2 μg/(kg·min),排除使用肾上腺素
    动脉血气分析 pH值7.3~7.5
    氧合指数 >300 mmHg
    血钠 <155 mmol/L
    血糖 <180 mg/dL(10 mmol/L)
    尿量 过去4 h内,>0.5 mL/(kg·h)
    下载: 导出CSV
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