中国肝移植受者肾损伤管理临床实践指南2023版

中华移植杂志（电子版）2023年12月第17卷第6期Chin J Transplant(Electronie Edition),December2023.Val.17.No.6·321··标准与指南·中国肝移植受者肾损伤管理临床实践指南(2023版)中华医学会器官移植学分会中国医师协会器官移植医师分会【摘要】肾损伤是肝移植术后常见并发症，主要包括急性肾损伤和慢性肾脏病。肝移植受者肾损伤严重影响受者长期生存和生活质量，是导致受者术后死亡的主要原因之一。为了规范化和优化肝移植受者肾损伤的诊疗，中华医学会器官移植学分会和中国医师协会器官移植医师分会组织专家在《中国肝移植受者肾损伤管理专家共识(2017版)》的基础上，结合近年来循证医学依据和我国临床实践经验，制订了《中国肝移植受者肾损伤管理临床实践指南(223版)》，以适应诊疗模式快速发展的新形势。本指南重点阐述肝移植受者肾损伤定义，分类、评估以及术前、术中和术后防治等内容，并科学规范地提出了系列推荐意见，旨在优化我国肝移植受者肾损伤管理。【关键词】肝移植；急性肾损伤；慢性肾脏病：肾损伤管理Clinical practice guidelines for kidney injury management of liver transplant recipients in China(2023 edition)Branch of Organ Transplant of Chinese Medical Association,Branch of OrganTransplant Physicians of Chinese Medical Doctor AssociationCorresponding author:Xu Xiao,Zhejiang University School of Medicine,Hangzhou 310003,Email:zpu@zju.edu.cn;Zheng Shusen,Zhejiang University School of Medicine,Hangzhou 310003,Email:zyzss@zju.edu.cn[Abstract]Kidney injury is a common complication after liver transplantation,including acutekidney injury and chronic kidney disease.Kidney injury in liver transplant recipients seriously affectstheir long-term survival and life quality,and is one of the main causes of death after livertransplantation.In order to standardize and optimize the diagnosis and treatment of kidney injury in livertransplant recipients,Branch of Organ Transplant of Chinese Medical Association and Branch of OrganTransplant Physicians of Chinese Medical Doctor Association organize experts to develop the "ClinicalPractice Guidelines for Kidney Injury Management of Liver Transplant Recipients in China (2023Edition)"to adapt to the rapid development of diagnosis and treatment.The guideline is based on"Chinese expert consensus on management of kidney injury in liver transplant recipients (2017edition)"and in conjunction with recent evidence-based medicine and clinical practice experience inChina.This guideline focuses on the definition,classification,assessment and preoperative,intraoperative and postoperative prevention and treatment of kidney injury in liver transplant recipients.By presenting a series of scientifically standardized recommendations,the guideline is aimed to optimizethe management of kidney injury in liver transplant recipients in China.[Key words]Liver transplantation;Acute kidney injury;Chronic kidney disease;Kidneyinjury management加，更可能引起感染、高血压病、营养不良、贫血、电1前言解质紊乱和骨质疏松等。严重的肾损伤可发展肾损伤作为肝移植术后常见并发症，不仅会导为终末期肾病(end-stage renal disease,ESRD),需行致受者住院频率增加、住院时间延长和治疗费用增肾脏替代治疗(renal replacement therapy,RRT)或肾移植，对肝移植受者长期生存和生活质量产生极大D0:10.3877/c4.j.isn.1674-3903.2023.06.001影响，是导致受者术后死亡的主要原因之一1,4。基金项目：国家自然科学基金重点项目(81930016)：国家重点肾损伤包括急性肾损伤(acute kidney injur町y,研发计划重点专项(2021YFA1100500)AKI)和慢性肾脏病(chronic kidney disease,CKD)。通信作者：徐骁，浙江大学医学院，310003杭州，Email:u@ju.edu.cn:郑树森，310003杭州，浙江大学医学院，Email:ys@由于定义标准和随访时间的不同，文献报道肝移植术zju.edu.cn后肾损伤发生率差异较大，AKI和CKD的发生率分