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Clinical management strategies for recipients with renal graft loss
Yang Hao, Lin Jun, Zhang Jian
 doi: 10.3969/j.issn.1674-7445.2023149
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With the maturity of kidney transplantation, introduction of new immunosuppressive drugs and improvement of immunosuppressive regimen, the short-term survival rate of kidney transplant recipients has been significantly improved, whereas the long-term survival rate has not been significantly elevated. Kidney transplant recipients may have the risk of renal graft loss. Clinical management after renal graft loss is complicated, including the adjustment of immunosuppressive drugs, management of renal graft and selection of subsequent renal replacement therapy. These management procedures directly affect clinical prognosis of patients with renal graft loss. Nevertheless, relevant guidelines or consensuses are still lacking. Clinical management of patients after renal graft loss highly depend upon clinicians’ experience. In this article, the adjustment of immunosuppressive drugs, management of renal graft and selection of subsequent renal replacement therapy were reviewed, aiming to provide reference for prolonging the survival and improving the quality of life of these patients.
Kidney xenotransplantation: status quo and development trend of physiological research
Song Jiahua, Yu Yifan, Deng Wenyi, Song Xiangqin, Jin Shuai, Li Tao, Qian Kun, Wang Yi
 doi: 10.3969/j.issn.1674-7445.2023148
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Organ transplantation is the most effective treatment for all categories of end-stage organ diseases. To resolve the shortage of donors in organ transplantation, widespread attention has been diverted to xenotransplantation. At present, clinicians mainly highlight the problems related to xenotransplantation rejection and viral infection. The physiology of xenotransplantation has been rarely studied. Kidney performs endocrine function by producing erythropoietin (EPO), renin and activating vitamin D. Although these pathways are usually well preserved in allogeneic transplantation, species-specific differences, especially those between pigs and nonhuman primates, may still affect the physiological function of transplant organs. In this article, the changes of EPO, renin-angiotensin-aldosterone system (RAAS) and active vitamin D3 of pig and human after xenotransplantation were illustrated, aiming to provide reference for subclinical research of xenotransplantation.
Chinese expert consensus on clinical application of inhibitors of mammalian target of rapamycin in liver transplant recipients (2023 edition)
Huo Feng, Xu Xiao, Ye Qifa, Xue Wujun, Committee of Health Management for Organ Transplant Recipient of China Organ Transplantation Development Foundation, Branch of Organ Transplant Physicians of Chinese Medical Doctor Association, Branch of Organ Transplant of Chinese Medical Association, National Center for Healthcare Quality Management in Liver Transplant
 doi: 10.3969/j.issn.1674-7445.2023167
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The long-term survival and quality of life of liver transplant recipients largely depend on long-term health management and immunosuppression regimen after surgery. Long-term use of immunosuppressants may lead to severe complications, such as kidney injury, metabolic diseases and new malignant tumors, and even increase the risk of liver cancer recurrence after liver transplantation. At present, common immunosuppressive regimens in liver transplant recipients are delivered based on calcineurin inhibitor (CNI). However, renal toxicity, neurotoxicity and increased tumor recurrence caused by CNI have significantly affected clinical prognosis of the recipients. In recent years, the dosage of CNI has been gradually reduced and alternative drugs have been explored. Recently, the use of immunosuppressive regimens based on mammalian target of rapamycin inhibitor (mTORi) has been gradually increased. Multiple domestic and international guidelines have provided guidance on the use of mTORi in liver transplant recipients. China Organ Transplantation Development Foundation organized experienced transplant experts in China, combined with published guidelines, consensus and research progress at home and abroad and solicited extensive opinions to jointly formulate this expert consensus, aiming to provide reference for liver transplant clinicians in China.
Effect of hypothermic machine perfusion on expression levels of inflammatory cytokines in rat kidney
Luo De, Liu Jiang, Zhou Pengcheng, Wang Piao, Li Xujia, Lin Haomin, Su Song
 doi: 10.3969/j.issn.1674-7445.2023132
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  Objective  To evaluate the effect of hypothermic machine perfusion (HMP) on the expression levels of inflammatory cytokines in rat kidney.   Methods  Thirty male rats were randomly divided into the control (Control group), static cold storage group (SCS group) and HMP group, with 10 rats in each group. The perfusion velocity, intrarenal resistance and pH value of perfusion effluent were recorded during HMP. The expression levels of CXC chemokine ligand (CXCL)1, CXCL2, interferon (IFN)-β1, IFN-α4, CC chemokine ligand (CCL)2, CCL20, interleukin (IL)-17α, IL-17c and tumor necrosis factor (TNF)-α messenger RNA (mRNA) in renal tissues were evaluated by reverse transcription polymerase chain reaction (RT-PCR). Pathological changes of the kidney were observed by hematoxylin-eosin (HE) staining.   Results  During HMP, the perfusion velocity and intrarenal resistance remained stable, and the pH value of perfusion effluent was decreased slowly. RT-PCR showed that the relative expression levels of CXCL1, CXCL2, CCL2, CCL20, IL-17α, IL-17c and TNF-α mRNA in the SCS and HMP groups were higher compared with those in the Control group. Compared with the SCS group, the relative expression levels of CXCL1, CXCL2, CCL2, CCL20, IL-17α and TNF-α mRNA were up-regulated in the HMP group (all P<0.05). HE staining revealed that the morphology of renal cells was normal in the Control group, whereas evident cell necrosis, cytoplasmic vacuolation, brush border loss and epithelial shedding were observed in the SCS group. Compared with the SCS group, pathological changes in the HMP group were alleviated.   Conclusions  HMP may activate renal inflammation, and inhibiting the activation of inflammation during HMP is expected to further improve the effect of allograft preservation.
ABO-incompatible living-related kidney transplantation: report of 23 cases
Shi Xiaofeng, Dou Gufeng, Du Qing, Guo Liping, Wang Zhen, Zhao Jie, Feng Gang, Mo Chunbai
 doi: 10.3969/j.issn.1674-7445.2023141
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Objective To evaluate clinical efficacy and safety of ABO-incompatible (ABOi) living-related kidney transplantation. Methods Clinical data of 23 recipients undergoing ABOi living-related kidney transplantation were retrospectively analyzed. According to the initial blood group antibody titers in the recipients before surgery, different individualized pretreatment regimens were adopted, including oral intake of immunosuppressive drugs plus rituximab, or oral intake of immunosuppressive drugs plus plasma exchange and/or double filtration plasmapheresis plus rituximab. The blood group antibody titers before and after pretreatment, before and after kidney transplantation, and perioperative renal function and related complications were monitored. Renal allograft function and related complications were observed during postoperative follow-up. Results Among 23 recipients undergoing ABOi living-related kidney transplantation, except for one case presenting with hyperacute rejection during operation, the serum creatinine levels of the remaining 22 recipients were restored normal. Perioperative complications included lymphatic fistula in 4 cases, 1 case of urinary fistula, 1 case of perirenal hematoma complicated with T cell-mediated rejection, 6 cases of urinary system infection, 1 case of acute tubular necrosis, 1 case of acute pancreatitis, 1 case of blood group antibody titer rebound, and 1 case of primary disease recurrence, and all of these complications were cured after corresponding treatment. During postoperative follow-up, the graft and recipient survival rates of 22 recipients were 100%, and renal allograft function was normal. The blood group antibody titer were all ≤1:8 during follow-up. Complications during follow-up included 2 cases of severe lung infection, 1 case of antibody-mediated rejection, 2 cases of primary disease recurrence, 1 case of lymphocyst, 1 case of urinary system infection, 1 case of herpes zoster, 1 case of BK viruria and 2 cases of abnormal blood glucose levels. Conclusions ABOi living-related kidney transplantation may be safely performed by selecting individualized pretreatment regimens according to antibody titers by different blood groups. However, high-dose rituximab or combined use of rabbit anti-human thymocyte immunoglobulin may cause severe infectious complications in highly sensitized recipients.
Current research status and prospect of organ donation discipline construction in China: a bibliometric analysis
Jiang Wenshi
 doi: 10.3969/j.issn.1674-7445.2023131
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  Objective  To explore the research status and development trend of organ donation discipline in China.   Methods  Relevant Chinese and English literatures related to organ donation were searched from China National Knowledge Infrastructure (CNKI) and Web of Science core collection database from January 1, 2018 to December 31, 2022. Visual analysis was performed by the CiteSpace software from the number of published articles, keywords, journal source distribution, cooperation network of core authors, main research institutions, and citation of key literatures, etc.   Results  A total of 792 articles were published from 2018 to 2022, with an average annual number of 158 articles, which showed a rapidly upward trend. Among them, 182 articles were published in the form of postgraduate dissertation, accounting for 23%. Common keywords included organ transplantation, brain death, cardiac death, willingness/cognition/attitude, legal system, influencing factor/risk factor, infection/complication, Organ Procurement Organization, prognosis/quality, education for college students/medical students, extracorporeal membrane oxygenation, children, ischemia-reperfusion injury, donor-derived infection, ethics, expended criteria donor, nursing and coordinator, etc. Keyword clustering hotspots focused on the theme of “organ donation” and branched into multiple disciplines. The publications of research results were characterized with pluralism and diversity, and the research contents were centered on medicine and spanned a wide range of disciplines. A large proportion of researches were published by the teams from large-scale organ transplantation institutions, and relatively close cooperative relationship was formed within the institutions. However, the intensity of cooperation among different institutions was relatively low, and the cooperative relationship among authors was insufficient, which failed to form an intimate academic network. The top five countries worldwide regarding the number of published articles were the U.S. (n=940), U.K. (n=377), Spain (n=263), Canada (n=241) and China (n=181), indicating that the achievements of Chinese researchers have been gradually recognized in the international academic community.   Conclusions  From the quantity and content of published articles in recent years, “organ donation” has laid certain research foundation in China. It is one of the topics concerned and widely studied by multiple academic communities in China. Relevant research issues have multidisciplinary, plural and diverse characteristics.
Transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation for Budd-Chiari syndrome complicated with liver cancer: a case report with surgical video
Ye Zhenghui, Zhao Hongchuan, Geng Xiaoping, Huang Fan, Wang Guobin, Wang Wei, Yu Xiaojun, Wu Ruolin, Hou Liujin, Zhang Xinghua, He Zhixiang
 doi: 10.3969/j.issn.1674-7445.2023116
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  Objective  To summarize clinical experience of transabdominal pericardial anastomosis of suprahepatic vena cava of the donor and right atrium of the recipient in liver transplantation for Budd-Chiari syndrome (BCS) complicated with liver cancer.   Methods  Clinical data of a BCS patient complicated with liver cancer undergoing transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium in liver transplantation were retrospectively analyzed.   Results  The hepatic vein and suprahepatic vena cava were partially occluded in the patient. Liver transplantation was completed by transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium with beating-heart. In addition, due to pathological changes of the recipient's hepatic artery, splenic artery of the recipient was cut off, distal ligation was performed, and the proximal end was reversed and anastomosed with the common hepatic artery of the donor liver, and the reconstruction of hepatic artery was completed. The surgery was successfully performed. At approximately postoperative 1 week, the function of the liver allograft was gradually restored to normal, and no major complications occurred. The patient was discharged at postoperative 25 d. No tumor recurrence was reported after 8-month follow-up.   Conclusions  It is safe and feasible to treat BCS by liver transplantation with transabdominal pericardial anastomosis of suprahepatic vena cava and right atrium. BCS patients complicated with liver cancer obtain favorable prognosis.
Progress in liver transplantation for intrahepatic cholangiocarcinoma
Wang Guoying, He Caihua
 doi: 10.3969/j.issn.1674-7445.2023144
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Intrahepatic cholangiocarcinoma (ICC) is a primary malignant tumor of the liver, secondary to hepatocellular carcinoma, and its incidence tends to elevate worldwide. Hepatectomy is the optimal surgical regimen for ICC patients. ICC is considered as a contraindication for liver transplantation due to high tumor recurrence rate and poor survival outcome. At present, multiple significant progresses have been made in liver transplantation for ICC. For strictly-selected ICC patients, liver transplantation or liver transplantation after neoadjuvant therapy has achieved encouraging survival outcomes. Meantime, with the improvement of prognostic risk stratification of liver transplantation for ICC, the inclusion criteria of ICC candidates undergoing liver transplantation will be further optimized. In addition, the advancement of modern multi-mode comprehensive treatment of ICC will further guide the selection of neoadjuvant therapy before liver transplantation for ICC. The application of immune checkpoint inhibitors in ICC before liver transplantation is also an important research direction in the future. In this article, clinical prognosis of liver transplantation for ICC, prognostic risk factors and inclusion criteria of ICC candidates undergoing liver transplantation, and the ongoing trials and existing challenges were summarized, aiming to provide reference for liver transplantation for ICC.
Research and application progress in adoptive re-transfusion of regulatory cells in organ transplantation
Wang Ruolin, Jia Ya’nan, Zhu Jiqiao, He Qiang, Li Xianliang
 doi: 10.3969/j.issn.1674-7445.2023103
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Rejection and adverse reactions caused by long-term use of immunosuppressants severely affect the survival rate and quality of life of organ transplant recipients. Immune tolerance induction plays a key role in improving the survival rate and quality of life of organ transplant recipients. In recent years, tremendous progress has been achieved in adoptive re-transfusion of regulatory cells. In this article, research progress in regulatory T cell (Treg), myeloid-derived suppressor cell (MDSC) and regulatory B cell (Breg) in animal experiment and clinical application was reviewed, and the main clinical problems of adoptive re-transfusion of regulatory cells, the application of chimeric antigen receptor Treg and the concept of cell therapy in immune evaluation were summarized, aiming to deepen the understanding of regulatory cell therapy, promote the application of regulatory cells in immune tolerance of organ transplantation, and improve clinical efficacy of organ transplantation and the quality of life of recipients.
Polarization of macrophage and its significance in acute rejection after intestinal transplantation
Luo Yang, Xu Xingwei, Ji Wu
 doi: 10.3969/j.issn.1674-7445.2023129
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  Objective  To investigate the changes of macrophage polarization during acute rejection (AR) after intestinal transplantation.   Methods  Six Brown Norway (BN) rats and 24 Lewis rats were divided into the sham operation group (6 Lewis rats), syngeneic transplantation group (Lewis→Lewis, 6 donors and 6 recipients) and allogeneic transplantation group (BN→Lewis, 6 donors and 6 recipients). At postoperative 7 d, the intestinal graft tissues in all groups were collected for hematoxylin-eosin (HE) staining and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) assay. Pathological manifestations and cell apoptosis were observed. The expression levels of serum cytokines related to M1 and M2 macrophage polarization were determined by enzyme-linked immunosorbent assay (ELISA). Surface markers of M1 and M2 macrophages of intestinal graft tissues in each group were co-localized and counted by immunofluorescence staining.   Results  HE staining and TUNEL assay showed that the intestinal epithelial morphology and structure were normal and no evident apoptotic bodies were found in the sham operation and syngeneic transplantation groups. At 7 d after transplantation, the epithelial villi structure of intestinal graft tissues was severely damaged, the number of crypts was decreased, the number of apoptotic bodies was increased, and inflammatory cells infiltrated into the whole intestinal wall, manifested with moderate to severe AR in the allogeneic transplantation group. ELISA revealed that the expression levels of serum cytokines related to M1 macrophage polarization, such as tumor necrosis factor (TNF)-α, interferon (IFN)-γand interleukin (IL)-12, of the recipient rats in the allogeneic transplantation group were higher than those in the sham operation and syngeneic transplantation groups. The expression levels of serum cytokines related to M2 macrophage polarization, such as IL-10 and transforming growth factor (TGF)-β, in the syngeneic transplantation group were higher compared with those in the sham operation and allogeneic transplantation group, and the differences were statistically significant (all P<0.05). Immunofluorescence staining showed that the number of M1 macrophages in the allogeneic transplantation group was higher than those in the sham operation and syngeneic transplantation groups, and the number of M2 macrophages in the syngeneic transplantation group was higher than those in the sham operation and allogeneic transplantation groups, and the differences were statistically significant (all P<0.05).   Conclusions  Among the allografts with AR after intestinal transplantation, a large number of macrophages, mainly M1 macrophages secreting a large number of pro-inflammatory cytokines, infiltrate into the whole intestinal wall. Regulating the direction of macrophage polarization is a potential treatment for AR after intestinal transplantation.
Guideline and Consensus
Expert consensus on diabetes mellitus after solid organ transplantation in adults
BI Yan, LU Bin, Organ Transplantation and Rehabilitation Committee of Chinese Medical Association of Rehabilitation
2023, 14(5): 623-642.   doi: 10.3969/j.issn.1674-7445.2023110
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Post-transplant diabetes mellitus (PTDM) is a common endocrine and metabolic disorder after adult solid organ transplant (SOT), affecting 10% to 40% of recipients. PTDM has been associated with increased mortality, heightened risk of infections, graft-related complications and cardiovascular diseases, all of which seriously threaten the quality of life and long-term survival of recipients. According to recent studies and the domestic healthcare system, this consensus provides a comprehensive overview of the epidemiology, risk factors, pathogenesis, screening and diagnosis, treatments, prevention strategies, cardiovascular risk factor management and microvascular complications associated with PTDM, in order to further standardize the diagnosis and treatment of PTDM. The objective is to standardize the comprehensive management of PTDM with the aim of enhancing the long-term quality of life and clinical outcomes for SOT recipients.
Editorial
Macrophages and kidney transplantation
Zheng Long, Cai Ming
2023, 14(5): 643-648.   doi: 10.3969/j.issn.1674-7445.2023139
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Kidney transplantation is the optimal treatment for patients with end-stage renal disease, whereas long-term survival of renal allografts remains a challenging issue. Renal ischemia-reperfusion injury (IRI) and rejection of renal allografts are considered as important influencing factors of long-term survival of renal allografts, which are regulated by innate and adaptive immune cells. Macrophages are one type of innate immune cells that could assist initiating adaptive immunity and are divided into M1, M2 and regulatory macrophages. Previous studies have revealed that M1 macrophages may aggravate renal IRI and acute T cell-mediated rejection (TCMR). However, M2 macrophages may mitigate renal IRI and acute TCMR, whereas it is positively correlated with antibody-mediated rejection (AMR). Regulatory macrophages are a special subgroup of macrophages, which may induce immune tolerance in organ transplantation and have promising clinical application prospects and basic scientific research value. In this article, the relationship among macrophage typing, macrophages and renal IRI, rejection of renal allografts, regulatory macrophages and immune tolerance was reviewed, and the potential mechanism was analyzed, aiming to induce changes in macrophage subtypes or eliminate specific subtypes of macrophages, thereby improving clinical prognosis of the recipients and long-term survival of renal allografts.
Transplantation Forefront
In vivo transplantation of eye organoids and application of tissue engineering scaffolds
Hu Leyi, Liu Zhenzhen, Liu Yizhi
2023, 14(5): 649-655.   doi: 10.3969/j.issn.1674-7445.2023059
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Eye organoid refers to a structure that possesses resembling cell types and functions to intraocular tissues, which is induced by stem cells in vitro. Transplanting it into the body for eye repair and regeneration is one of the key research directions in regenerative medicine, which also provides a novel direction and strategy for the treatment of major blinding diseases. As a carrier of biological tissue or cell growth, tissue engineering scaffold could support in vivo transplantation of eye organoids and promote their maturation. Organic combination of eye organoids and tissue engineering is a critical approach to realize in vivo integration of eye organoids and reconstruct corresponding structures and functions. In this review, the latest research status of eye organoids and in vivo transplantation were summarized, and relevant studies of tissue engineering scaffold-assisted eye organoid transplantation were highlighted, aiming to provide ideas and reference for subsequent inter-disciplinary research of eye organoids and tissue engineering.
Effect of nuclear factor E2-related factor 2 on renal ischemia-reperfusion injury
Li Xiaofeng, Zhang Guoxin, Yang Kaiyin, Zhang Lingyun
2023, 14(5): 656-661.   doi: 10.3969/j.issn.1674-7445.2023124
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Renal ischemia-reperfusion injury (RIRI) is the main cause of acute kidney injury (AKI), which commonly occurs in surgery, severe trauma, shock and drug-induced kidney injury. At present, effective treatment for RIRI is still lacking. Oxidative stress is the major pathological injury mechanism of RIRI. Nuclear factor E2-related factor 2 (Nrf2) is the key transcription factor of anti-oxidative stress response, which may activate various cytoprotective genes related to redox and detoxification. Recent studies have shown that Nrf2 may play a protective role in the protection and treatment of RIRI by regulating oxidative stress, inflammation, cell apoptosis and autophagy, etc. Consequently, the structure and biological function of Nrf2, related signaling pathways, its role in the incidence and development of RIRI and potential mechanism were reviewed in this article, aiming to provide novel ideas for the prevention and treatment of RIRI.
Role and prospect of ferroptosis in ischemia-reperfusion injury during organ transplantation
Li Jiawei, Xu Hongyang
2023, 14(5): 662-668.   doi: 10.3969/j.issn.1674-7445.2023058
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Ferroptosis is a newly-emerged pattern of programmed cell death discovered in recent years, which is defined as iron-dependent programmed necrosis mediated by lipid peroxidation damage. As a conservative procedure, ferroptosis plays a vital role in the development and diseases of multiple organisms including plants and animals. Since ferroptosis was first reported in 2012, growing interests have been diverted to the process of ferroptosis and its role in disease treatment. Ischemia-reperfusion injury is a common pathological process during organ transplantation, and ferroptosis is considered as one of the main patterns inducing ischemia-reperfusion injury. Consequently, the definition, regulatory mechanism and the mechanisms of ferroptosis in ischemia-reperfusion injury after kidney, liver, heart and lung transplantations were reviewed, aiming to provide theoretical basis for the prevention and treatment of ischemia-reperfusion injury in organ transplantation.
Original Article
Effect of body mass index of recipients on early prognosis after lung transplantation
Wang Dapeng, Li Xiaoshan, Xu Zhongping, Liang Chenglong, Hu Chunxiao, Xu Hongyang
2023, 14(5): 669-675.   doi: 10.3969/j.issn.1674-7445.2023081
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  Objective  To evaluate the effect of body mass index (BMI) on early prognosis of the recipients after lung transplantation.   Methods  Clinical data of 307 lung transplant recipients were retrospectively analyzed. According to preoperative BMI, all recipients were divided into the low (BMI <18.5 kg/m2, n=114), normal (18.5 kg/m2≤BMI <24 kg/m2, n=145) and high (BMI≥24.0 kg/m2, n=48) BMI groups, respectively. Baseline data including age, sex, blood type, BMI, preoperative complications, preoperative pulmonary hypertension, and intraoperative use of extracorporeal membrane oxygenation (ECMO) of all recipients were compared among three groups. The survival rate of all recipients was estimated by Kaplan-Meier curve and the survival curve was delineated. The differences of survival rate were analyzed by log-rank test. The 30-, 90- and 180-d mortality risk of all recipients after lung transplantation in different BMI groups was compared by multivariate Cox regression analysis.   Results  There were significant differences in age and sex of recipients among three groups (both P<0.05). There was a significant difference regarding the 180-d survival rate after lung transplantation among different BMI groups (P<0.05). Multivariate Cox regression analysis showed that the 90-d mortality risk after lung transplantation in the high BMI group was 2.295 times higher than that in the normal BMI group [hazard ratio (HR) 2.295, 95% confidence interval (CI) 1.064-4.947, P=0.034]. In the high BMI group, the 180-d mortality risk after lung transplantation was 2.783 times higher compared with that in the normal BMI group (HR 2.783, 95%CI 1.333-5.810, P=0.006), and the 180-d mortality risk in the low BMI group was 2.181 times higher than that in the normal BMI group (HR 2.181, 95%CI 1.124-4.232, P=0.021).   Conclusions  Compared with the recipients with normal BMI, their counterparts with high and low preoperative BMI have higher mortality risk early after lung transplantation. Adjusting preoperative BMI to normal range contributes to improving early prognosis of lung transplant recipients.
Changes of postoperative pulmonary function in lung transplant recipients
Cai Yuhang, Lian Qiaoyan, Wang Xiaohua, Chen Ao, Wang Lulin, Yang Yalan, Xu Yu, He Jianxing, Ju Chunrong
2023, 14(5): 676-682.   doi: 10.3969/j.issn.1674-7445.2023092
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  Objective  To analyze the changes of postoperative pulmonary function in lung transplant recipients.   Methods  Clinical data of 81 recipients undergoing bilateral lung transplantation and combined heart-lung transplantation were collected, and postoperative status of the recipients was analyzed. Pulmonary ventilation and diffusion function indexes at 1 month, 3 months, every 3 months (3-18 months after lung transplantation) and every 6 months (18-36 months after lung transplantation) were analyzed in the recipients. The characteristics of the optimal pulmonary function in the recipients were assessed.   Results  Postoperative mechanical ventilation time was 4 (2, 9) d, and the length of postoperative ICU stay was 10 (7, 20) d. Among 81 recipients, 27 recipients developed primary graft dysfunction (PGD) after lung transplantation, with an incidence rate of 33%. Postoperative forced vital capacity (FVC) to predicted value ratio (FVC%pred), forced expiratory volume in one second (FEV1) to predicted value ratio (FEV1%pred), FEV1/FVC to predicted value ratio (FEV1/FVC%pred) and corrected diffusion lung capacity for CO to predicted value ratio (DLCOc%pred) were changed over time (all P<0.001). FVC%pred and FEV1%pred were gradually increased within postoperative 9 months, and DLCOc%pred was gradually elevated within postoperative 3 months (all P<0.05). Thirty-six recipients had FVC%pred≥80%, FEV1%pred≥80% in 41 cases, FEV1/FVC%pred≥92% in 76 cases, FVC%pred≤40% in 1 case and FEV1%pred≤40% in 1 case, respectively. Sixteen recipients had DLCOc%pred≥80%, corrected diffusion lung capacity for CO/alveolar volume to predicted value ratio (DLCOc/VA%pred) ≥80% in 63 cases, DLCOc%pred≤40% in 4 cases and DLCOc/VA%pred≤40% in 1 case, respectively. Postoperative FVC%pred, FEV1/FVC%pred and DLCOc%pred in recipients with a primary disease of obstructive pulmonary disease were significantly higher than those in their counterparts with restrictive pulmonary disease (all P<0.05). Postoperative DLCOc%pred in recipients with PGD was significantly lower than that in those without PGD (P<0.05).   Conclusions  Pulmonary ventilation function in lung transplant recipients reaches the optimal state and maintains a steady state at postoperative 9 months, and pulmonary diffusion function reaches a steady state at postoperative 3 months. Primary diseases and the incidence of PGD may affect postoperative pulmonary function.
Attitudes and influencing factors of transplantation-related populations towards kidney xenotransplantation
Xu Ying, Chen Jiahong, He Songzhe, Li Tao, Qi Jinhao, Wang Yi
2023, 14(5): 683-690.   doi: 10.3969/j.issn.1674-7445.2023118
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  Objective  To investigate the attitudes and influencing factors of transplantation-related populations towards kidney xenotransplantation.   Methods  From June 2022 to January 2023, stratified random sampling was performed from patients awaiting kidney transplantation, patients after kidney transplantation, patients' relatives and medical students. Four hundred subjects were collected from each population and 1600 subjects were investigated using a self-designed questionnaire. Baseline data of the respondents, their attitudes towards kidney xenotransplantation and the reasons of rejecting kidney xenotransplantation were analyzed. The influencing factors of attitudes towards kidney xenotransplantation were also identified.   Results  A total of 1 493 valid questionnaires were collected, and the questionnaire retrieval rate was 93.31%. About 93.10% of the respondents accepted allogeneic kidney transplantation, and 66.78% had heard of kidney xenotransplantation. Seven hundred and ninety-five respondents suggested that they could accept kidney xenotransplantation "when kidney xenotransplantation and allogeneic kidney transplantation yielded the same results and risks". Six hundred and ninety-eight respondents indicated that they were "unable" or "uncertain" whether they could accept kidney xenotransplantation (χ2=16.409, P=0.001). Among these 698 respondents, the proportion of them who were willing to accept kidney xenotransplantation when they did not meet the conditions of allogeneic kidney transplantation was 10.9%. About 35.8% of respondents were willing to accept kidney xenotransplantation if it yielded less risk and better prognosis compared with allogeneic kidney transplantation. If the time of awaiting kidney xenotransplantation was shorter than that of allogeneic kidney transplantation, 21.2% were willing to accept kidney xenotransplantation. If the cost of kidney xenotransplantation was less than that of allogeneic kidney transplantation, 24.5% of them were willing to accept kidney xenotransplantation. The main reasons of rejecting kidney xenotransplantation included surgical risk and other unknown risks. Multivariate analysis showed that respondents residing in cities and towns for a long period of time, those who accept allogeneic kidney transplantation and those who have heard of kidney xenotransplantation showed more positive attitudes towards kidney xenotransplantation.   Conclusions  Different transplantation-related populations have different attitudes towards kidney xenotransplantation, and the overall attitudes are positive. Active promotion of kidney xenotransplantation research and carrying out relevant popular science education contribute to improving public attitudes towards the acceptance of kidney xenotransplantation.
Risk factors of new-onset hypertriglyceridemia in kidney transplant recipients: a single-center analysis
Xu Yuan, Yang Bo, Chen Chengxin, Zhu Kejing, Niu Yulin, Li Haiyang
2023, 14(5): 691-699.   doi: 10.3969/j.issn.1674-7445.2023055
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  Objective  To identify the risk factors of new-onset hypertriglyceridemia (HTG) in kidney transplant recipients.   Methods  Clinical data of 149 kidney transplant recipients were retrospectively analyzed. According to serum triglyceride (TG) level after operation, they were divided into the non-HTG group (TG≤1.7 mmol/L, n=60) and new-onset HTG group (TG>1.7 mmol/L, n=89). Baseline data of all recipients were compared between two groups. The risk factors of HTG in kidney transplant recipients were analyzed by generalized estimating equation (GEE), and validated by multiple regression equations.   Results  No significant differences were observed in baseline data between two groups (all P>0.05). Multivariate analysis showed that the incidence of HTG in the middle and high tacrolimus (Tac) concentration groups was higher than that in the low Tac concentration group [odds ratio (OR) 3.11, 95% confidence interval (CI) 1.22-7.93, P=0.018 in the middle Tac concentration group; OR 5.11, 95%CI 1.31-19.98, P=0.019 in the high Tac concentration group]. Compared with type-A blood recipients, the risk of new-onset HTG was significantly increased in type-O blood counterparts (OR 2.77, 95%CI 1.14-6.71, P=0.024). The risk of new-onset HTG was decreased along with the increase of preoperative globulin level (OR 0.93, 95%CI 0.87-0.99, P=0.043). At postoperative 3 months, Tac blood concentration in the new-onset HTG group was significantly higher compared with that in the non-HTG group, and significant difference was observed (P<0.05). Multiple regression equations confirmed that the risk of new-onset HTG in type-O blood kidney transplant recipients was higher than that in type-A blood counterparts, and the risk of new-onset HTG in the middle and high Tac concentration groups was higher than that in the low Tac concentration group (all P<0.05).   Conclusions  Type-O blood kidney transplant recipients are more prone to HTG. It is necessary to strengthen postoperative monitoring and control of blood lipids. The blood concentration of Tac probably affects the new-onset HTG in kidney transplant recipients. Maintaining an appropriate blood concentration of Tac may be beneficial to lowering the risk of HTG.
Epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients : a single-center retrospective study
Wei Fen, Li Ning, Wang Mingjun, Guo Xiaohong
2023, 14(5): 700-707.   doi: 10.3969/j.issn.1674-7445.2023098
Abstract(95) HTML(58) PDF 530KB()
Abstract:
  Objective  To investigate the epidemiological characteristics of SARS-CoV-2 pneumonia in kidney transplant recipients and analyze the risk and protective factors of severe/critical infection with SARS-CoV-2.   Methods  Clinical data of 468 kidney transplant recipients infected with SARS-CoV-2 were retrospectively analyzed. According to the severity of infection, they were divided into mild SARS-CoV-2 infection recipients (n=439) and SARS-CoV-2 pneumonia group (n=29). Among the 439 mild SARS-CoV-2 infection recipients, 87 recipients who were randomly matched with their counterparts in the SARS-CoV-2 pneumonia group according to sex, age and transplantation time at a ratio of 3∶1 were allocated into the mild SARS-CoV-2 infection group. Twenty-nine recipients in the SARS-CoV-2 pneumonia group were divided into the moderate SARS-CoV-2 pneumonia group (n=21) and severe/critical SARS-CoV-2 pneumonia group (n=8). Baseline data of all recipients were collected. The risk and protective factors of SARS-CoV-2 infection in kidney transplant recipients were identified.   Results  The proportion of recipients complicated with 2-3 types of complications in the SARS-CoV-2 pneumonia group was higher than that in the mild SARS-CoV-2 infection group, and the proportion of recipients treated with tacrolimus(Tac)+mizoribine+glucocorticoid immunosuppression regimen in the SARS-CoV-2 pneumonia group was lower than that in the mild SARS-CoV-2 infection group, and significant differences were observed (both P<0.05). In 29 kidney transplant recipients with SARS-CoV-2 pneumonia in the SARS-CoV-2 pneumonia group, white blood cells, the absolute values of lymphocytes, eosinophils, total T cells, CD4+T cells and CD8+T cells, and serum uric acid levels were significantly lower, whereas ferritin levels were significantly higher than the values prior to SARS-CoV-2 pneumonia, and significant differences were observed (all P<0.05). Compared with the moderate SARS-CoV-2 pneumonia group, the proportion of recipients with hypoxemia was higher, the proportion of recipients treated with Tac/ciclosporin (CsA)+mycophenolate mofetil+glucocorticoid immunosuppression regimen was higher, and the proportion of recipients administered with 2-3 doses of SARS-CoV-2 vaccine was lower in the severe/critical SARS-CoV-2 pneumonia group, and significant differences were observed (all P<0.05).   Conclusions  More complications and immunosuppression regimen containing mycophenolate mofetil are the risk factor for SARS-CoV-2 infection in kidney transplant recipients. Vaccination with SARS-CoV-2 vaccine and immunosuppression regimen containing mizoribine are probably the protective factors for lowering the risk of SARS-CoV-2 infection. The levels of inflammatory cytokines are associated with the severity of SARS-CoV-2 pneumonia.
Portal vein aneurysm after liver transplantation: report of two cases and literature review
Zhao Hongqiang, Dong Cao’er, Hou Yucheng, Wu Guangdong, Tong Xuan, Li Ang, Yu Lihan, Lu Qian, Xu Guangxun, Chen Hong, Tang Rui
2023, 14(5): 708-713.   doi: 10.3969/j.issn.1674-7445.2023105
Abstract(127) HTML(80) PDF 1555KB()
Abstract:
  Objective   To summarize the diagnosis and treatment experience of portal vein aneurysm after liver transplantation.   Methods  Clinical data of two recipients with portal vein aneurysm after liver transplantation were retrospectively analyzed. Clinical features, diagnosis, treatment and prognosis were summarized based on literature review.   Results  Both two cases were diagnosed with intrahepatic portal vein aneurysm complicated with portal vein thrombosis and portal hypertension after liver transplantation. Case 1 was given with targeted conservative treatment and he refused to undergo liver retransplantation. Physical condition was worsened after discharge, and the patient eventually died from liver graft failure, kidney failure, lung infection, and septic shock. Case 2 received high-dose glucocorticoid pulse therapy, whereas liver function was not improved, and the patient was recovered successfully after secondary liver transplantation.   Conclusions  Long-term complication of portal vein aneurysm (especially intrahepatic type) after liver transplantation probably indicates poor prognosis. Correct understanding, intimate follow-up and active treatment should be conducted. Liver retransplantation may be a potential treatment regimen.
Construction of post competency model of human organ donation coordinators based on onion model
Wu Jianquan, Shang Manman, Zheng Guifang, Wei Qin, Xie Xianyu, Li Yueping
2023, 14(5): 714-722.   doi: 10.3969/j.issn.1674-7445.2023100
Abstract(103) HTML(62) PDF 1066KB()
Abstract:
  Objective  To construct a scientific and rational post competency model of human organ donation coordinators.   Methods  Based on the onion model, the index pool was initially constructed by literature research and behavioral event interview. The index system was screened, modified and improved using Delphi method. The weight of indexes at all levels was determined by analytic hierarchy process.   Results  The effective response rates of two rounds of Delphi expert inquiries were both 100%, indicating that the expert opinions were highly dependable. The experts' judgment coefficient (Ca), familiarity (Cs) and authoritative coefficient (Cr) were all above 0.7, indicating that the experts' opinions were highly reliable. The expert coordination coefficients (W) were 0.294 and 0.342 (both P<0.001), indicating that experts delivered coordinated opinions and yielded slight difference in understanding the importance of indexes. Finally, according to the "onion model" theory and experts' opinions, a set of coordinator's post competency model including 6 first-level and 55 second-level indexes was established, which comprised an index surface layer, a middle layer and a core layer. Among them, the core layer represented core professional values, the middle layer was personal quality and professional ethics and quality, and the surface layer was interpersonal communication capability, organizational cooperation capability and professional knowledge and lifelong learning capability.   Conclusions  The post competency model of organ donation coordinators established in this study consists of 6 first-level and 55 second-level indexes, which is highly effective and reliable.
Review Article
Research progress on the role of macrophages in renal allograft fibrosis
Ren Difei, Wang Yuchen, Miao Yun
2023, 14(5): 723-729.   doi: 10.3969/j.issn.1674-7445.2023084
Abstract(116) HTML(70) PDF 519KB()
Abstract:
Ischemia-reperfusion injury, rejection, nephrotoxicity caused by calcineurin inhibitors and other factors cause excessive accumulation of renal extracellular matrix after kidney transplantation, which gradually induce renal fibrosis and eventually lead to renal failure. In recent years, the mechanism of macrophages in renal allograft fibrosis has gradually captivated widespread attention. Studies have shown that some drugs like mammalian target of rapamycin inhibitors may mitigate renal allograft fibrosis through the macrophage. In this article, the main pathogenesis and pathophysiological mechanism of renal allograft fibrosis, the role of different macrophages in the progression of renal allograft fibrosis, the infiltration of peripherally-recruited macrophages and renal resident macrophages into renal injury areas, the induction of myofibroblasts by macrophages and potential treatment regimens of macrophage-associated renal allograft fibrosis were reviewed, aiming to provide reference for investigating the role of macrophages in renal allograft fibrosis.
Research progress on kidney transplantation rejection associated with non-HLA antibody
Zhang Shuyu, Li Yuehong
2023, 14(5): 730-735.   doi: 10.3969/j.issn.1674-7445.2023101
Abstract(115) HTML(60) PDF 572KB()
Abstract:
Human leukocyte antigen (HLA) is a product encoded by HLA gene complex, which is located on the short arm of chromosome 6 and is the main target of alloimmunity. However, positive HLA antibody is not responsible for all kinds of rejections in kidney transplantation. Non-HLA antibody is the product of donor gene expression in allogeneic kidney transplantation. Intraoperative ischemia-reperfusion injury, the interaction between alloimmunity and autoimmunity and the mediation of extracellular vesicles may trigger immune system response and promote the production of non-HLA antibody. Multiple studies have demonstrated that non-HLA antibody is an important factor of inducing rejection and affecting the outcomes of kidney transplantation. Consequently, the types and formation mechanism of non-HLA antibody in kidney transplantation were reviewed, and research progress on kidney transplantation rejection associated with non-HLA antibody was summarized, aiming to provide reference for in-depth study of kidney transplantation rejection associated with non-HLA antibody.
The role of neutrophil extracellular trap in the diagnosis and treatment of complications after liver transplantation
Liu Yanyao, Qin Xiaoyan, Wu Zhongjun
2023, 14(5): 736-744.   doi: 10.3969/j.issn.1674-7445.2023093
Abstract(90) HTML(57) PDF 578KB()
Abstract:
Prevention and treatment of complications after liver transplantation play a significant role in maintaining liver graft function and improving clinical prognosis of the recipients. Neutrophil extracellular trap (NET) are fibrous net-like structures composed of DNA as the skeleton and histones and granular proteins released by activated neutrophils. Studies have shown that the activation of neutrophils and the release of NET in donor liver after liver transplantation are involved in the incidence of multiple liver transplantation-related complications including ischemia-reperfusion injury, acute rejection, acute liver failure and recurrence of hepatocellular carcinoma, etc. In this article, the effect of NET on the complications after liver transplantation was mainly assessed, and research progress on NET as a potential target for the prevention and treatment of complications after liver transplantation was reviewed, aiming to provide reference for the prevention and treatment of complications after liver transplantation, enhance clinical efficacy of liver transplantation and improve clinical prognosis of the recipients.
Advances in application of regulatory T cells in transplant immune tolerance: from basic to clinical research
Hu Lu, Nian Yeqi
2023, 14(5): 745-753.   doi: 10.3969/j.issn.1674-7445.2023049
Abstract(106) HTML(69) PDF 582KB()
Abstract:
Regulatory T cells (Treg) are important inhibitory immune cells to establish immune tolerance, which play a pivotal role in regulating excessive immune response and autoimmune diseases of the host. Previous studies related to transplant immune tolerance have confirmed that increasing the number of Treg in vivo or enhancing the function of Treg serve as a therapeutic strategy to induce transplant immune tolerance. At present, Treg-based induction methods for transplant immune tolerance include adoptive infusion of Treg, in vivo amplification of Treg and utilization of antigen-specific Treg. In this article, the characteristics and mechanism of Treg, the latest research progress on basic experiments and clinical practice of Treg related to transplant immune tolerance at home and abroad were reviewed, and future challenges and development of Treg therapy were prospected, aiming to unravel the significance and application prospect of Treg in transplant immune tolerance, explore the advantages and limitations of Treg therapeutic strategies, and provide reference and evidence for subsequent research in this field.
Transmission of porcine endogenous retrovirus in xenotransplantation
Yu Yifan, Song Jiahua, Song Xiangqin, Li Tao, Jiang Jian, Bai Yunhao, Wang Yi
2023, 14(5): 754-759.   doi: 10.3969/j.issn.1674-7445.2023293
Abstract(119) HTML(77) PDF 534KB()
Abstract:
Organ transplantation is the most effective treatment for various types of end-stage diseases. To resolve the problem of donor shortage in organ transplantation, the possibility of xenotransplantation has been gradually explored by surgeons. Pig is one of the common donor sources for xenotransplantation. As a bridge between two species, the viruses carried by pig organs may be transmitted between species and cause the risk of zoonosis. Porcine endogenous retrovirus (PERV) is integrated into the genome, which is a category of retrovirus featuring cross-species transmission. In this article, the influencing factors of transmission characteristics of PERV, the transmission risk of PERV and its recombinant virus, and the detection and transmission risk assessment of PERV in xenotransplantation test were reviewed, aiming to provide reference for alleviating severe shortage of donor organs and driving the advancement of xenotransplantation technologies.
Progress in self-expanding metallic ureteral stent in the treatment of ureteral stricture in renal allografts
Chen Yuantang, Zheng Jiefang, Liang Peng, Zhang Zhiming, Jiang Xianhan, Li Tian
2023, 14(5): 760-764.   doi: 10.3969/j.issn.1674-7445.2023127
Abstract(44) HTML(19) PDF 497KB()
Abstract:
Ureteral stricture in renal allografts is one of the common postoperative complications in kidney transplant recipients. Due to short ureter in renal allografts, endovascular treatment should be adopted before reconstruction surgery to avoid irreversible injury. Alleviating renal allograft injury, easing obstruction or establishing drainage channel are the key measures to treat ureteral stricture. In endovascular treatment, balloon dilatation and internal incision yield high recurrence rate, and long-term indwelling of self-expanding metallic ureteral stents may be a better option. Compared with traditional stents, metallic stents may maintain urinary tract patency for a long time and mitigate the irritation of lower urinary tract symptoms,with different indications and efficacy. Although all metallic stents may be displaced and occluded, it still plays a positive role in the treatment of ureteral stricture in renal allografts. In this article, the application of self-expanding metallic ureteral stent in ureteral stricture of renal allografts was mainly illustrated, aiming to provide reference for optimizing the treatment of ureteral stricture in renal allografts.
Guideline on immunosuppressive therapy of recipients with renal transplantation in China(2016 edition)
2016, 7(5): 327-331.   doi: 10.3969/j.issn.1674-7445.2016.05.001
Abstract(1078) HTML(846) PDF 201KB(281)
摘要:
为提高临床医师对肾移植受者免疫抑制治疗的认识, 规范国内肾移植受者管理, 帮助医师在肾移植临床实践中做出合理决策, 我们组织专家制订了《中国肾移植受者免疫抑制治疗指南(2016版)》。该指南以《2009版改善全球肾病预后组织(KDIGO)肾移植受者管理指南》为主要参考, 结合我国的临床实践经验, 希望能为相关临床科室提供工作指引。
Development status of organ transplantation in China: the report on the 2018 Annual Meeting of Organ Transplantation of Chinese Medical Association
Shi Bingyi
2019, 10(1): 32-35.   doi: 10.3969/j.issn.1674-7445.2019.01.004
Abstract(1292) HTML(716) PDF 886KB(138)
摘要:
我国的器官移植事业正处于由数量规模型发展向高质量和高科技含量提升、由移植大国向移植强国冲刺的历史关键时期。在2018年中华医学会器官移植学年会上,主任委员石炳毅教授从中国器官捐献与移植体系建设、中国器官移植发展现状两大方面,作了“继往开来,中国器官移植的发展现状”的报告。新的历史时期赋予我们新的历史使命,器官移植学分会要主动作为,推动科学发展,为贯彻新理念、拓宽新视野、实现新愿景而努力奋斗。
Technical specifcation for clinical application of immunosuppressive agents in organ transplantation (2019 edition)
Branch of Organ Transplantation of Chinese Medical Association
2019, 10(3): 213-226.   doi: 10.3969/j.issn.1674-7445.2019.03.001
Abstract(1176) HTML(1566) PDF 1076KB(436)
摘要:
为了进一步规范器官移植免疫抑制剂的临床应用,中华医学会器官移植学分会组织全国31家移植中心的器官移植专家,从器官移植免疫诱导药物应用技术规范、器官移植维持期免疫抑制剂应用技术规范、器官移植常用免疫抑制方案技术规范、器官移植免疫抑制剂血药浓度监测技术规范、器官移植药物性肝肾损伤治疗技术规范等方面,制订本规范,以帮助器官移植工作者规范和优化器官移植免疫抑制剂的临床应用。
Clinical guideline on living donor renal transplantation in China (2016 edition)
2016, 7(6): 417-426.   doi: 10.3969/j.issn.1674-7445.2016.06.002
Abstract(1631) HTML(666) PDF 323KB(287)
摘要:
活体供肾移植经历半个多世纪的发展,已成为终末期肾病患者的重要治疗手段。在我国,亲属活体器官捐献肾移植作为家庭自救的方式之一,近年来已成为肾脏供体来源的重要补充部分。本指南以世界卫生组织《人体器官移植指导原则》(1991)、中华人民共和国国务院《人体器官移植条例》(2007)以及国家卫生部《关于规范活体器官移植的若干规定》(2010)为法律依据,在《中国活体供肾移植指南》(2009)的基础上进行更新。内容包括活体供肾移植的伦理学、供者与受者的医学评估、活体供肾摘取原则与手术方式、供者近期与远期并发症以及供者的长期随访等。
Technical specification for the diagnosis and treatment on rejection of renal transplantation (2019 edition)
Branch of Organ Transplantation of Chinese Medical Association
2019, 10(5): 505-512.   doi: 10.3969/j.issn.1674-7445.2019.05.008
Abstract(819) HTML(589) PDF 882KB(252)
摘要:
为了进一步规范肾移植排斥反应的临床诊断与治疗, 中华医学会器官移植学分会组织器官移植学专家, 总结各移植中心的肾移植临床经验, 在《中国肾脏移植排斥反应临床诊疗指南(2016版)》的基础上, 并依据Banff标准, 从超急性排斥反应、急性加速性排斥反应、急性排斥反应、慢性排斥反应等方面, 制订本规范。
2019, 10(2): 142-148.   doi: 10.3969/j.issn.1674-7445.2019.02.005
Abstract(1274) HTML(1266) PDF 7197KB(302)
摘要:
为了进一步规范中国实体器官移植(SOT)受者巨细胞病毒(CMV)感染的诊断和治疗,中华医学会器官移植学分会组织器官移植专家、感染病学专家及呼吸内科专家,在《实体器官移植受者巨细胞病毒感染诊疗指南(2017版)》的基础上,从CMV感染的主要危险因素、实验室诊断、临床类型、预防方案,CMV病的治疗,儿童SOT术后CMV感染或CMV病的防治,CMV肺炎合并伊氏肺孢子菌肺炎的防治等方面,制订本规范,以期为我国SOT术后CMV感染的规范化防治提供指导意见。
Branch of Organ Transplantation of Chinese Medical Association Process and specification of Chinese donation after citizen′s death (2019 edition)
Branch of Organ Transplantation of Chinese Medical Association
2019, 10(2): 122-127.   doi: 10.3969/j.issn.1674-7445.2019.02.003
Abstract(2505) HTML(1194) PDF 5080KB(152)
摘要:
为了进一步规范中国公民逝世后器官捐献的流程,中华医学会器官移植学分会组织器官移植和器官捐献相关专家,从报名登记、捐献评估、捐献确认、器官获取、器官分配、遗体处理、人道救助、捐献文书归档等8个环节,制定中国公民逝世后器官捐献流程和规范(2019版)。
Technical specifcation for clinical diagnosis and treatment for invasive fungal disease in organ transplant recipients (2019 edition)
Branch of Organ Transplantation of Chinese Medical Association
2019, 10(3): 227-236.   doi: 10.3969/j.issn.1674-7445.2019.03.002
Abstract(485) HTML(438) PDF 2552KB(165)
摘要:
为了进一步规范实体器官移植(SOT)受者侵袭性真菌病(IFD)的诊断和治疗,中华医学会器官移植学分会结合近期国内外临床证据,从SOT受者IFD的流行病学特点、诊断、预防、治疗等方面,在2017年版《器官移植受者侵袭性真菌病临床诊疗指南》的基础上制定本规范,以期为器官移植和相关学科的同道提供帮助。
Guideline on the standard of lung transplantation donors and the acquisition and transshipment in China
Branch of Organ Transplantation of Chinese Medical Association, National Quality Management and Control Center for Lung Transplantation
2018, 9(5): 325-333.   doi: 10.3969/j.issn.1674-7445.2018.05.001
Abstract(703) HTML(246) PDF 1533KB(60)
摘要:
2015年我国供肺利用率仅约5%。从器官获取组织(OPO)进行供肺协调、初步评估和维护,到供肺获取直至最后经民航、高速公路、高铁转运完成肺移植,每一环节都相当艰难。许多初评合格的供肺,由于缺乏有效的维护而无法用于移植。因此,我们组织专家制订我国肺移植供体标准及获取转运指南,从我国肺移植供肺捐献的分类、供肺选择标准、供肺维护策略、供肺获取流程、供肺转运流程等方面,总结我国肺移植的临床实践经验,希望能为肺移植相关临床科室提供工作指引。
Summary of important research on liver transplantation in 2017
Li Haibo, Fu Hongyuan, Lu Tongyu, Zeng Kaining, Zhang Yingcai, Yang Yang
2018, 9(1): 41-50,82.   doi: 10.3969/j.issn.1674-7445.2018.01.006
Abstract(720) HTML(495) PDF 1280KB(20)
摘要:
肝移植是目前公认的治疗终末期肝病的最有效措施。经过超过50年的发展,肝移植患者术后存活时间不断延长,并发症的发生率亦有所降低。但是,如何改善供肝短缺的现状、减轻供肝缺血-再灌注损伤,减少并发症的发生率以及进一步提高肝移植患者的远期疗效仍然是困扰肝移植科医师的难题。因此,了解最新的外科技术、多中心临床经验以及相关基础研究结果,将帮助我们更深入地认识疾病本质,为患者制定更妥善的治疗方案。本文综合国际核心期刊报道的内容,对2017年度肝移植相关领域的研究热点及最新进展作一综述,并对今后的研究方向作出展望。
Chinese expert consensus on organ protection of transplantation (2022 edition)
China Liver Transplant Registry, National Center for Healthcare Quality Management in Liver Transplant, National Quality Control Center for Human Donated Organ Procurement, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, Committee on Transplant Organ Quality Control, Branch of Organ Transplant Physicians of Chinese Medical Doctor Association, Organ Procurement and Allocation Working Committee of the China Hospital Association, National Trauma Medical Center Organ Protection Committee
2022, 13(2): 144-160.   doi: 10.3969/j.issn.1674-7445.2022.02.002
Abstract(1776) HTML(551) PDF 18636KB(551)
Abstract:
Organ transplantation is the most effective treatment for end-stage organ failure, and voluntary donation after citizen's death is the only source of transplant organ in China. Clinically, transplant organ protection technique plays a critical role in improving the quality of transplant organs and the prognosis of recipients. On the basis of domestic and worldwide basic research and clinical practice of transplant organ protection and according to the Oxford evidence classification and GRADE system, the experts organized by Branch of Organ Transplant Physicians of Chinese Medical Doctor Association, Branch of Transplantation Group of Surgery of Chinese Medical Association and China Liver Transplant Registry Scientific Committee had compiled and published the Chinese Expert Consensus on Organ Protection of Transplantation (2016 edition) for liver, kidney, pancreas, small intestine, heart, lung transplant organs. With the support of China Liver Transplant Registry, National Trauma Medical Center, National Quality Control Center for Human Donated Organ Procurement, National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation and National Center for Healthcare Quality Management in Liver Transplant combined with recent domeatic and worldwide clinical practice and research progress for organ transplantation and organ protection, the Chinese Expert Consensus on Organ Protection of Transplantation (2022 edition) has been published recently. This consensus focuses on updating the technical progress and evidence-based medicine of organ procurement, preservation, transport, and quality evaluation in clinical practice. Additionally, the content of composite tissue transplantation mainly including limb transplantation has also been covered. The aim is to promote the the scientific and standardized clinical organ transplantation.
Overview of global organ donation and transplantation in 2020
Jiang Wenshi, Sun Yongkang, Yan Juan, Jiang Feng, Wang Huiying, Ma Qiruo, Xie Ying, He Xiangxiang, Wu Xiaotong
2021, 12(4): 376-383.   doi: 10.3969/j.issn.1674-7445.2021.04.002
Abstract(2632) HTML(3441) PDF 1734KB(3441)
Abstract:
  Objective  At present, the novel coronavirus pneumonia (COVID-19) pandemic is still raging in certain regions around the globe, and the prevention and control of the pandemic should be strengthened. Under the challenges of respective social environment and allocation of medical resources, and support from the inertia and inherent productivity of the system on which the industry depends, extensive attempts are being delivered to push forward the work of organ donation and transplantation in each country. Under the guidance of national experts and committee members, Shanxi Provincial Human Organ Procurement and Allocation Service Center was established on August 28, 2018 approved by the former Shanxi Provincial Health and Family Planning Commission. It is the only independent non-profit medical institution in Shanxi Province. In this article, the system construction of citizen's organ donation and transplantation fitting national and provincial conditions was further explored according to the data analysis of organ donation and transplantation in the United States and Spain during the COVID-19 pandemic combined with the implementation of organ donation work in Shanxi Provincial Human Organ Procurement and Allocation Service Center.

Competent Authorities: Ministry of Education of the People's Republic of China

Sponsored by: Sun Yat-sen University

Presented by: The Third Affiliated Hospital of Sun Yat-sen University

Editor-in-Chief: Gui-Hua Chen

Publisher: Editorial Office of Organ Transplantation

Address: The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Tianhe District, Guangzhou

Postcode: 510630

Tel: 020-38736410

Email: organtranspl@163.com

Postal Code: 46-35

Website: http://www.organtranspl.com

Journal: bimonthly

Price: 20 yuan for each period and 120 yuan for the whole year

CN 44-1665/R

ISSN 1674-7445

Open Access