Chinese guidelines for minimally invasive donor hepatectomy in living donor liver transplantation (2024 edition).

IF 6.1 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Hepatobiliary surgery and nutrition Pub Date : 2024-12-01 Epub Date: 2024-11-20 DOI:10.21037/hbsn-24-329
Xi Xu, Tao Lv, Gang Xu, Qiang Wei, Qi Ling, Lin Wei, Jianhua Li, Jiakai Zhang, Yang Cai, Jinzhen Cai, Guihua Chen, Zhishui Chen, Zhonghua Chen, Ying Cheng, Jian Dou, Shunda Du, Chengyou Du, Zhiren Fu, Zhiyong Guo, Lianghui Gao, Xiaoshun He, Qiang He, Lei Huang, Jianzhao Huang, Feng Huo, Changku Jia, Chen Jin, Wentao Jiang, Jipin Jiang, Zuoyi Jiao, Hong-En Jing, Ren Lang, Bo Li, Li Li, Ning Li, Qiyong Li, Wengang Li, Yumin Li, Guangming Li, Jun Liu, Lei Liu, Jingfeng Liu, Lianxin Liu, Zuojin Liu, Shichun Lu, Qian Lu, Ling Lv, Yi Lv, Guoyue Lv, Tingbo Liang, Yingzi Ming, Zhihai Peng, Jianghua Ran, Jun Shi, Beicheng Sun, Chengyi Sun, Xuyong Sun, Yuling Sun, Zhongzhou Si, Yingmei Shao, Jiulin Song, Kaishan Tao, Mujian Teng, Yunle Wan, Xueshuai Wan, Liming Wang, Hao Wen, Gang Wu, Jian Wu, Xiangwei Wu, Zhongjun Wu, Lai Wei, Jian Xu, Jun Xu, Yang Yang, Hongji Yang, Zhanyu Yang, Zhaoxu Yang, Jian Yang, Qifa Ye, Shuhong Yi, Jian Zhou, Feng Zhang, Lei Zhang, Min Zhang, Wu Zhang, Leida Zhang, Shuijun Zhang, Shunyun Zhao, Hong Zheng, Lin Zhong, Haitao Zhu, Jiye Zhu, Xiaofeng Zhu, Zhijun Zhu, Hong Wu, Wenzhi Guo, Zhengxin Wang, Xiao Xu, Jiayin Yang
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引用次数: 0

Abstract

Background: Minimally invasive surgeries are increasingly central to modern medicine, particularly in liver transplantation. These techniques, which offer reduced trauma, precise operations, minimal bleeding, and swift recovery, are, however, unevenly adopted across China. Only a limited number of centers routinely perform minimally invasive donor hepatectomies, indicating a significant imbalance in the development and application of these advanced procedures. Additionally, there lacks a set of standardized guidelines that are tailored to meet China's unique healthcare challenges and conditions.

Methods: In August 2023, the Branch of Organ Transplant of Chinese Medical Association and the Branch of Organ Transplant Physicians of Chinese Medical Doctor Association convened a group of national liver transplantation experts to establish a guideline development committee. This committee conducted a thorough review of relevant literature, evaluated existing guidelines and consensus, and assessed factors such as the evidence base, patient preferences, and the cost-effectiveness of interventions within China. After multiple rounds of discussions, both online and offline, the committee finalized the guidelines.

Results: This collaborative effort led to the creation of the "Chinese guidelines for minimally invasive donor hepatectomy in living donor liver transplantation (2024 edition)". These guidelines address crucial aspects such as the safety and advantages of minimally invasive surgery for living donor liver transplantation, donor selection criteria, anesthesia strategies, surgical technical details, and learning curves associated with these procedures, resulting in a comprehensive set of 26 recommendations.

Conclusions: The formulation of these guidelines represents a significant advancement towards standardizing minimally invasive liver transplantation surgeries in China. They are designed to enhance outcomes for both donors and recipients by synthesizing expert consensus with contemporary research and clinical practices. Moreover, they serve as a crucial reference for surgeons and medical institutions, promoting the refinement and adoption of minimally invasive surgical techniques in liver transplantation.

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中国活体肝移植微创供体肝切除术指南(2024 年版)》。
背景:微创手术日益成为现代医学的核心,尤其是在肝脏移植手术中。微创手术创伤小、操作精确、出血少、术后恢复快,但在中国的采用情况却参差不齐。只有少数中心常规开展微创供体肝切除术,这表明这些先进手术的发展和应用严重失衡。此外,中国缺乏一套针对中国独特医疗挑战和条件的标准化指南:2023 年 8 月,中华医学会器官移植分会和中国医师协会器官移植医师分会召集全国肝移植专家成立了指南制定委员会。该委员会对相关文献进行了全面梳理,对现有指南和共识进行了评估,并对中国的证据基础、患者偏好和干预措施的成本效益等因素进行了评估。经过多轮在线和离线讨论,委员会最终确定了指南:在各方的共同努力下,《中国活体肝移植微创供体肝切除术指南(2024 年版)》应运而生。这些指南涉及活体肝移植微创手术的安全性和优势、供体选择标准、麻醉策略、手术技术细节以及与这些手术相关的学习曲线等关键方面,形成了一套26条建议的综合指南:这些指南的制定标志着中国在实现微创肝移植手术标准化方面取得了重大进展。通过综合专家共识、当代研究和临床实践,这些指南旨在提高供体和受体的治疗效果。此外,该指南还可作为外科医生和医疗机构的重要参考,促进肝移植微创手术技术的完善和应用。
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来源期刊
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期刊介绍: Hepatobiliary Surgery and Nutrition (HBSN) is a bi-monthly, open-access, peer-reviewed journal (Print ISSN: 2304-3881; Online ISSN: 2304-389X) since December 2012. The journal focuses on hepatopancreatobiliary disease and nutrition, aiming to present new findings and deliver up-to-date, practical information on diagnosis, prevention, and clinical investigations. Areas of interest cover surgical techniques, clinical and basic research, transplantation, therapies, NASH, NAFLD, targeted drugs, gut microbiota, metabolism, cancer immunity, genomics, and nutrition and dietetics. HBSN serves as a valuable resource for professionals seeking insights into diverse aspects of hepatobiliary surgery and nutrition.
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